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US9655614B2 - Robotically-controlled motorized surgical instrument with an end effector - Google Patents

Robotically-controlled motorized surgical instrument with an end effector
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US9655614B2
US9655614B2US13/792,263US201313792263AUS9655614B2US 9655614 B2US9655614 B2US 9655614B2US 201313792263 AUS201313792263 AUS 201313792263AUS 9655614 B2US9655614 B2US 9655614B2
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Prior art keywords
closure
end effector
surgical
drive
tool
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US13/792,263
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US20130193189A1 (en
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Brett E. Swensgard
David C. Yates
Frederick E. Shelton, IV
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Cilag GmbH International
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Ethicon Endo Surgery LLC
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Priority claimed from US12/235,972external-prioritypatent/US9050083B2/en
Priority to US13/792,263priorityCriticalpatent/US9655614B2/en
Application filed by Ethicon Endo Surgery LLCfiledCriticalEthicon Endo Surgery LLC
Assigned to ETHICON ENDO-SURGERY, INC.reassignmentETHICON ENDO-SURGERY, INC.ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS).Assignors: SHELTON, FREDERICK E., IV, YATES, DAVID C., SWENSGARD, BRETT E.
Publication of US20130193189A1publicationCriticalpatent/US20130193189A1/en
Assigned to ETHICON ENDO-SURGERY, LLCreassignmentETHICON ENDO-SURGERY, LLCASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS).Assignors: ETHICON ENDO-SURGERY INC.
Priority to US15/274,784prioritypatent/US10105136B2/en
Priority to US15/274,826prioritypatent/US10130361B2/en
Priority to US15/274,805prioritypatent/US10045778B2/en
Priority to US15/274,847prioritypatent/US10238389B2/en
Assigned to ETHICON LLCreassignmentETHICON LLCCHANGE OF NAME (SEE DOCUMENT FOR DETAILS).Assignors: ETHICON ENDO-SURGERY, LLC
Publication of US9655614B2publicationCriticalpatent/US9655614B2/en
Application grantedgrantedCritical
Priority to US16/146,367prioritypatent/US10980534B2/en
Priority to US16/146,335prioritypatent/US10765425B2/en
Priority to US16/903,803prioritypatent/US11045189B2/en
Priority to US16/903,791prioritypatent/US10980535B2/en
Assigned to CILAG GMBH INTERNATIONALreassignmentCILAG GMBH INTERNATIONALASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS).Assignors: ETHICON LLC
Priority to US17/242,766prioritypatent/US11812954B2/en
Priority to US17/709,590prioritypatent/US11648005B2/en
Priority to US17/719,501prioritypatent/US20220240930A1/en
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Abstract

A surgical tool configured for operation in connection with a robotic system. The surgical tool includes a shaft and an end effector extending distally from the shaft. The end effector comprises a first jaw member and a second jaw member movable relative to the first jaw member from a closed position to an open position in response to at least one axial motion. In addition, the surgical tool includes a motor configured to generate at least one rotational motion and a motion conversion assembly operably coupled to the motor and the second jaw member, wherein the motion conversion assembly is configured to convert the at least one rotational motion to the at least one axial motion.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS
This non-provisional patent application is a continuation patent application under 35 U.S.C. §120 of and claims the benefit from U.S. patent application Ser. No. 13/118,253, filed May 27, 2011, entitled “Robotically-Controlled Motorized Surgical Instrument”, now U.S. Pat. No. 9,386,983, which is a continuation-in-part patent application under 35 U.S.C. §120 of and claims the benefit from U.S. patent application Ser. No. 12/235,972, filed Sep. 23, 2008, entitled “Motorized Surgical Instrument”, now U.S. Pat. No. 9,050,083, the entire disclosures of which are hereby incorporated by reference herein.
BACKGROUND
Surgical staplers have been used in the prior art to simultaneously make a longitudinal incision in tissue and apply lines of staples on opposing sides of the incision. Such instruments commonly include a pair of cooperating jaw members that, if the instrument is intended for endoscopic or laparoscopic applications, are capable of passing through a cannula passageway. One of the jaw members receives a staple cartridge having at least two laterally spaced rows of staples. The other jaw member defines an anvil having staple-forming pockets aligned with the rows of staples in the cartridge. Such instruments typically include a plurality of reciprocating wedges that, when driven distally, pass through openings in the staple cartridge and engage drivers supporting the staples to effect the firing of the staples toward the anvil.
An example of a surgical stapler suitable for endoscopic applications is described in published U.S. Patent Application Publication No. 2004/0232196 A1, now U.S. Pat. No. 7,000,818, entitled, “Surgical Stapling Instrument Having Separate Distinct Closing And Firing Systems,” the disclosure of which is herein incorporated by reference. In use, a clinician is able to close the jaw members of the stapler upon tissue to position the tissue prior to firing. Once the clinician has determined that the jaw members are properly gripping tissue, the clinician can fire the surgical stapler, thereby severing and stapling the tissue. The simultaneous severing and stapling steps avoid complications that may arise when performing such actions sequentially with different surgical tools that respectively only sever or staple.
Motor-powered surgical cutting and fastening instruments, where a motor powers the cutting instrument, are also known in the prior art, such as described in published U.S. Patent Application Publication No. 2007/0175962 A1, entitled “Motor-Driven Surgical Cutting And Fastening Instrument With Tactile Position Feedback,” now U.S. Pat. No. 7,422,139, which is incorporated herein by reference. In this reference, a battery in the handle is used to electrically power the motor.
FIGURES
Various embodiments of the present invention are described herein by way of example in conjunction with the following figures, wherein:
FIGS. 1 and 2 are perspective views of a surgical cutting and fastening instrument according to various embodiments of the present invention;
FIGS. 3-5 are exploded views of an end effector and shaft of the instrument according to various embodiments of the present invention;
FIG. 6 is a side view of the end effector according to various embodiments of the present invention;
FIG. 7 is an exploded view of the handle of the instrument according to various embodiments of the present invention;
FIGS. 8 and 9 are partial perspective views of the handle according to various embodiments of the present invention;
FIG. 10 is a side view of the handle according to various embodiments of the present invention;
FIG. 11 is a schematic diagram of a circuit used in the instrument according to various embodiments of the present invention;
FIGS. 12-14 and 17 are schematic diagrams of circuits used to power the motor of the instrument according to various embodiments of the present invention;
FIG. 15 is a block diagram illustrating a charge management circuit according to various embodiments of the present invention;
FIG. 16 is a block diagram illustrating a charger base according to various embodiments of the present invention;
FIG. 18 illustrates a typical power curve of a battery;
FIGS. 19 and 20 are schematic diagrams of circuits used in the instrument according to various embodiments of the present invention;
FIGS. 21 and 23 are diagrams of instruments according to various embodiments of the present invention;
FIGS. 22 and 24 are diagrams of battery packs according to various embodiments of the present invention;
FIG. 25 is a perspective view of one robotic controller embodiment;
FIG. 26 is a perspective view of one robotic surgical arm cart/manipulator of a robotic system operably supporting a plurality of surgical tool embodiments of the present invention;
FIG. 27 is a side view of the robotic surgical arm cart/manipulator depicted inFIG. 26;
FIG. 28 is a perspective view of an exemplary cart structure with positioning linkages for operably supporting robotic manipulators that may be used with various surgical tool embodiments of the present invention;
FIG. 29 is a perspective view of a surgical tool embodiment of the present invention;
FIG. 30 is an exploded assembly view of an adapter and tool holder arrangement for attaching various surgical tool embodiments to a robotic system;
FIG. 31 is a side view of the adapter shown inFIG. 30;
FIG. 32 is a bottom view of the adapter shown inFIG. 30;
FIG. 33 is a top view of the adapter ofFIGS. 30 and 31;
FIG. 34 is a partial bottom perspective view of the surgical tool embodiment ofFIG. 29;
FIG. 35 is a partial exploded view of a portion of an articulatable surgical end effector embodiment of the present invention;
FIG. 36 is a perspective view of the surgical tool embodiment ofFIG. 34 with the tool mounting housing removed;
FIG. 37 is a rear perspective view of the surgical tool embodiment ofFIG. 34 with the tool mounting housing removed;
FIG. 38 is a front perspective view of the surgical tool embodiment ofFIG. 34 with the tool mounting housing removed;
FIG. 39 is a partial exploded perspective view of the surgical tool embodiment ofFIG. 38;
FIG. 40 is a partial cross-sectional side view of the surgical tool embodiment ofFIG. 34;
FIG. 41 is an enlarged cross-sectional view of a portion of the surgical tool depicted inFIG. 37;
FIG. 42 is an exploded perspective view of a portion of the tool mounting portion of the surgical tool embodiment depicted inFIG. 34;
FIG. 43 is an enlarged exploded perspective view of a portion of the tool mounting portion ofFIG. 42;
FIG. 44 is a partial cross-sectional view of a portion of the elongated shaft assembly of the surgical tool ofFIG. 34;
FIG. 45 is a side view of a half portion of a closure nut embodiment of a surgical tool embodiment of the present invention;
FIG. 46 is a perspective view of another surgical tool embodiment of the present invention;
FIG. 47 is a cross-sectional side view of a portion of the surgical end effector and elongated shaft assembly of the surgical tool embodiment ofFIG. 46 with the anvil in the open position and the closure clutch assembly in a neutral position;
FIG. 48 is another cross-sectional side view of the surgical end effector and elongated shaft assembly shown inFIG. 47 with the clutch assembly engaged in a closure position;
FIG. 49 is another cross-sectional side view of the surgical end effector and elongated shaft assembly shown inFIG. 47 with the clutch assembly engaged in a firing position;
FIG. 50 is a top view of a portion of a tool mounting portion embodiment of the present invention;
FIG. 51 is a perspective view of another surgical tool embodiment of the present invention;
FIG. 52 is a cross-sectional side view of a portion of the surgical end effector and elongated shaft assembly of the surgical tool embodiment ofFIG. 51 with the anvil in the open position;
FIG. 53 is another cross-sectional side view of a portion of the surgical end effector and elongated shaft assembly of the surgical tool embodiment ofFIG. 51 with the anvil in the closed position;
FIG. 54 is a perspective view of a closure drive nut and portion of a knife bar embodiment of the present invention;
FIG. 55 is a top view of another tool mounting portion embodiment of the present invention;
FIG. 56 is a perspective view of another surgical tool embodiment of the present invention;
FIG. 57 is a cross-sectional side view of a portion of the surgical end effector and elongated shaft assembly of the surgical tool embodiment ofFIG. 56 with the anvil in the open position;
FIG. 58 is another cross-sectional side view of a portion of the surgical end effector and elongated shaft assembly of the surgical tool embodiment ofFIG. 57 with the anvil in the closed position;
FIG. 59 is a cross-sectional view of a mounting collar embodiment of a surgical tool embodiment of the present invention showing the knife bar and distal end portion of the closure drive shaft;
FIG. 60 is a cross-sectional view of the mounting collar embodiment ofFIG. 59;
FIG. 61 is a top view of another tool mounting portion embodiment of another surgical tool embodiment of the present invention;
FIG. 61A is an exploded perspective view of a portion of a gear arrangement of another surgical tool embodiment of the present invention;
FIG. 61B is a cross-sectional perspective view of the gear arrangement shown inFIG. 61A;
FIG. 62 is a cross-sectional side view of a portion of a surgical end effector and elongated shaft assembly of another surgical tool embodiment of the present invention employing a pressure sensor arrangement with the anvil in the open position;
FIG. 63 is another cross-sectional side view of a portion of the surgical end effector and elongated shaft assembly of the surgical tool embodiment ofFIG. 62 with the anvil in the closed position;
FIG. 64 is a side view of a portion of another surgical tool embodiment of the present invention in relation to a tool holder portion of a robotic system with some of the components thereof shown in cross-section;
FIG. 65 is a side view of a portion of another surgical tool embodiment of the present invention in relation to a tool holder portion of a robotic system with some of the components thereof shown in cross-section;
FIG. 66 is a side view of a portion of another surgical tool embodiment of the present invention with some of the components thereof shown in cross-section;
FIG. 67 is a side view of a portion of another surgical end effector embodiment of a portion of a surgical tool embodiment of the present invention with some components thereof shown in cross-section;
FIG. 68 is a side view of a portion of another surgical end effector embodiment of a portion of a surgical tool embodiment of the present invention with some components thereof shown in cross-section;
FIG. 69 is a side view of a portion of another surgical end effector embodiment of a portion of a surgical tool embodiment of the present invention with some components thereof shown in cross-section;
FIG. 70 is an enlarged cross-sectional view of a portion of the end effector ofFIG. 69;
FIG. 71 is another cross-sectional view of a portion of the end effector ofFIGS. 69 and 70;
FIG. 72 is a cross-sectional side view of a portion of a surgical end effector and elongated shaft assembly of another surgical tool embodiment of the present invention with the anvil in the open position;
FIG. 73 is an enlarged cross-sectional side view of a portion of the surgical end effector and elongated shaft assembly of the surgical tool embodiment ofFIG. 72;
FIG. 74 is another cross-sectional side view of a portion of the surgical end effector and elongated shaft assembly ofFIGS. 72 and 73 with the anvil thereof in the closed position;
FIG. 75 is an enlarged cross-sectional side view of a portion of the surgical end effector and elongated shaft assembly of the surgical tool embodiment ofFIGS. 72-74;
FIG. 76 is a top view of a tool mounting portion embodiment of a surgical tool embodiment of the present invention;
FIG. 77 is a perspective assembly view of another surgical tool embodiment of the present invention;
FIG. 78 is a front perspective view of a disposable loading unit arrangement that may be employed with various surgical tool embodiments of the present invention;
FIG. 79 is a rear perspective view of the disposable loading unit ofFIG. 78;
FIG. 80 is a bottom perspective view of the disposable loading unit ofFIGS. 78 and 79;
FIG. 81 is a bottom perspective view of another disposable loading unit embodiment that may be employed with various surgical tool embodiments of the present invention;
FIG. 82 is an exploded perspective view of a mounting portion of a disposable loading unit depicted inFIGS. 78-80;
FIG. 83 is a perspective view of a portion of a disposable loading unit and an elongated shaft assembly embodiment of a surgical tool embodiment of the present invention with the disposable loading unit in a first position;
FIG. 84 is another perspective view of a portion of the disposable loading unit and elongated shaft assembly ofFIG. 83 with the disposable loading unit in a second position;
FIG. 85 is a cross-sectional view of a portion of the disposable loading unit and elongated shaft assembly embodiment depicted inFIGS. 83 and 84;
FIG. 86 is another cross-sectional view of the disposable loading unit and elongated shaft assembly embodiment depicted inFIGS. 83-85;
FIG. 87 is a partial exploded perspective view of a portion of another disposable loading unit embodiment and an elongated shaft assembly embodiment of a surgical tool embodiment of the present invention;
FIG. 88 is a partial exploded perspective view of a portion of another disposable loading unit embodiment and an elongated shaft assembly embodiment of a surgical tool embodiment of the present invention;
FIG. 89 is another partial exploded perspective view of the disposable loading unit embodiment and an elongated shaft assembly embodiment ofFIG. 88;
FIG. 90 is a top view of another tool mounting portion embodiment of a surgical tool embodiment of the present invention;
FIG. 91 is a side view of another surgical tool embodiment of the present invention with some of the components thereof shown in cross-section and in relation to a robotic tool holder of a robotic system;
FIG. 92 is an exploded assembly view of a surgical end effector embodiment that may be used in connection with various surgical tool embodiments of the present invention;
FIG. 93 is a side view of a portion of a cable-driven system for driving a cutting instrument employed in various surgical end effector embodiments of the present invention;
FIG. 94 is a top view of the cable-driven system and cutting instrument ofFIG. 93;
FIG. 95 is a top view of a cable drive transmission embodiment of the present invention in a closure position;
FIG. 96 is another top view of the cable drive transmission embodiment ofFIG. 95 in a neutral position;
FIG. 97 is another top view of the cable drive transmission embodiment ofFIGS. 95 and 96 in a firing position;
FIG. 98 is a perspective view of the cable drive transmission embodiment in the position depicted inFIG. 95;
FIG. 99 is a perspective view of the cable drive transmission embodiment in the position depicted inFIG. 96;
FIG. 100 is a perspective view of the cable drive transmission embodiment in the position depicted inFIG. 97;
FIG. 101 is a perspective view of another surgical tool embodiment of the present invention;
FIG. 102 is a side view of a portion of another cable-driven system embodiment for driving a cutting instrument employed in various surgical end effector embodiments of the present invention;
FIG. 103 is a top view of the cable-driven system embodiment ofFIG. 102;
FIG. 104 is a top view of a tool mounting portion embodiment of another surgical tool embodiment of the present invention;
FIG. 105 is a top cross-sectional view of another surgical tool embodiment of the present invention;
FIG. 106 is a cross-sectional view of a portion of a surgical end effector embodiment of a surgical tool embodiment of the present invention;
FIG. 107 is a cross-sectional end view of the surgical end effector ofFIG. 106 taken along line107-107 inFIG. 106;
FIG. 108 is a perspective view of the surgical end effector ofFIGS. 106 and 107 with portions thereof shown in cross-section;
FIG. 109 is a side view of a portion of the surgical end effector ofFIGS. 106-108;
FIG. 110 is a perspective view of a sled assembly embodiment of various surgical tool embodiments of the present invention;
FIG. 111 is a cross-sectional view of the sled assembly embodiment ofFIG. 110 and a portion of the elongated channel ofFIG. 109;
FIGS. 112-117 diagrammatically depict the sequential firing of staples in a surgical tool embodiment of the present invention;
FIG. 118 is a partial perspective view of a portion of a surgical end effector embodiment of the present invention;
FIG. 119 is a partial cross-sectional perspective view of a portion of a surgical end effector embodiment of a surgical tool embodiment of the present invention;
FIG. 120 is another partial cross-sectional perspective view of the surgical end effector embodiment ofFIG. 119 with a sled assembly axially advancing therethrough;
FIG. 121 is a perspective view of another sled assembly embodiment of another surgical tool embodiment of the present invention;
FIG. 122 is a partial top view of a portion of the surgical end effector embodiment depicted inFIGS. 119 and 120 with the sled assembly axially advancing therethrough;
FIG. 123 is another partial top view of the surgical end effector embodiment ofFIG. 122 with the top surface of the surgical staple cartridge omitted for clarity;
FIG. 124 is a partial cross-sectional side view of a rotary driver embodiment and staple pusher embodiment of the surgical end effector depicted inFIGS. 119 and 120;
FIG. 125 is a perspective view of an automated reloading system embodiment of the present invention with a surgical end effector in extractive engagement with the extraction system thereof;
FIG. 126 is another perspective view of the automated reloading system embodiment depicted inFIG. 125;
FIG. 127 is a cross-sectional elevational view of the automated reloading system embodiment depicted inFIGS. 125 and 126;
FIG. 128 is another cross-sectional elevational view of the automated reloading system embodiment depicted inFIGS. 125-127 with the extraction system thereof removing a spent surgical staple cartridge from the surgical end effector;
FIG. 129 is another cross-sectional elevational view of the automated reloading system embodiment depicted inFIGS. 125-127 illustrating the loading of a new surgical staple cartridge into a surgical end effector;
FIG. 130 is a perspective view of another automated reloading system embodiment of the present invention with some components shown in cross-section;
FIG. 131 is an exploded perspective view of a portion of the automated reloading system embodiment ofFIG. 130;
FIG. 132 is another exploded perspective view of the portion of the automated reloading system embodiment depicted inFIG. 131;
FIG. 133 is a cross-sectional elevational view of the automated reloading system embodiment ofFIGS. 130-132;
FIG. 134 is a cross-sectional view of an orientation tube embodiment supporting a disposable loading unit therein;
FIG. 135 is a perspective view of another surgical tool embodiment of the present invention;
FIG. 136 is a partial perspective view of an articulation joint embodiment of a surgical tool embodiment of the present invention;
FIG. 137 is a perspective view of a closure tube embodiment of a surgical tool embodiment of the present invention;
FIG. 138 is a perspective view of the closure tube embodiment ofFIG. 137 assembled on the articulation joint embodiment ofFIG. 136;
FIG. 139 is a top view of a portion of a tool mounting portion embodiment of a surgical tool embodiment of the present invention;
FIG. 140 is a perspective view of an articulation drive assembly embodiment employed in the tool mounting portion embodiment ofFIG. 139;
FIG. 141 is a perspective view of another surgical tool embodiment of the present invention; and
FIG. 142 is a perspective view of another surgical tool embodiment of the present invention.
DETAILED DESCRIPTION
Applicant of the present application also owns the following patent applications that were filed on May 27, 2011 and which are each herein incorporated by reference in their respective entireties:
    • U.S. patent application Ser. No. 13/118,259, entitled “Surgical Instrument With Wireless Communication Between a Control Unit of a Robotic System and Remote Sensor”, now U.S. Pat. No. 8,684,253;
    • U.S. patent application Ser. No. 13/118,210, entitled “Robotically-Controlled Disposable Motor Driven Loading Unit”, now U.S. Pat. No. 8,752,749;
    • U.S. patent application Ser. No. 13/118,194, entitled “Robotically-Controlled Endoscopic Accessory Channel”, now U.S. Pat. No. 8,992,422;
    • U.S. patent application Ser. No. 13/118,278, entitled “Robotically-Controlled Surgical Stapling Devices That Produce Formed Staples Having Different Lengths”, now U.S. Pat. No. 9,237,891;
    • U.S. patent application Ser. No. 13/118,190, entitled “Robotically-Controlled Motorized Cutting and Fastening Instrument”, now U.S. Pat. No. 9,179,912;
    • U.S. patent application Ser. No. 13/118,223, entitled “Robotically-Controlled Shaft Based Rotary Drive Systems For Surgical Instruments”, now U.S. Pat. No. 8,931,682;
    • U.S. patent application Ser. No. 13/118,263, entitled “Robotically-Controlled Surgical Instrument Having Recording Capabilities”, now U.S. Patent Application Publication No. 2011/0295295;
    • U.S. patent application Ser. No. 13/118,272, entitled “Robotically-Controlled Surgical Instrument With Force Feedback Capabilities”, now U.S. Patent Application Publication No. 2011/0290856;
    • U.S. patent application Ser. No. 13/118,246, entitled “Robotically-Driven Surgical Instrument With E-Beam Driver”, now U.S. Pat. No. 9,060,770; and
    • U.S. patent application Ser. No. 13/118,241, entitled “Surgical Stapling Instruments With Rotatable Staple Deployment Arrangements”, now U.S. Pat. No. 9,072,535.
Certain exemplary embodiments will now be described to provide an overall understanding of the principles of the structure, function, manufacture, and use of the devices and methods disclosed herein. One or more examples of these embodiments are illustrated in the accompanying drawings. Those of ordinary skill in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments and that the scope of the various embodiments of the present invention is defined solely by the claims. The features illustrated or described in connection with one exemplary embodiment may be combined with the features of other embodiments. Such modifications and variations are intended to be included within the scope of the present invention.
Uses of the phrases “in various embodiments,” “in some embodiments,” “in one embodiment”, or “in an embodiment”, or the like, throughout the specification are not necessarily all referring to the same embodiment. Furthermore, the particular features, structures, or characteristics of one or more embodiments may be combined in any suitable manner in one or more other embodiments. Such modifications and variations are intended to be included within the scope of the present invention.
FIGS. 1 and 2 depict a surgical cutting andfastening instrument10 according to various embodiments of the present invention. The illustrated embodiment is an endoscopic instrument and, in general, the embodiments of theinstrument10 described herein are endoscopic surgical cutting and fastening instruments. It should be noted, however, that according to other embodiments of the present invention, the instrument may be a non-endoscopic surgical cutting and fastening instrument, such as a laparoscopic instrument.
Thesurgical instrument10 depicted inFIGS. 1 and 2 comprises ahandle6, ashaft8, and an articulatingend effector12 pivotally connected to theshaft8 at anarticulation pivot14. Anarticulation control16 may be provided adjacent to thehandle6 to effect rotation of theend effector12 about thearticulation pivot14. In the illustrated embodiment, theend effector12 is configured to act as an endocutter for clamping, severing and stapling tissue, although, in other embodiments, different types of end effectors may be used, such as end effectors for other types of surgical devices, such as graspers, cutters, staplers, clip appliers, access devices, drug/gene therapy devices, ultrasound, RF or laser devices, etc. More details regarding RF devices may be found in the '312 patent.
Thehandle6 of theinstrument10 may include aclosure trigger18 and a firingtrigger20 for actuating theend effector12. It will be appreciated that instruments having end effectors directed to different surgical tasks may have different numbers or types of triggers or other suitable controls for operating theend effector12. Theend effector12 is shown separated from thehandle6 by a preferablyelongate shaft8. In one embodiment, a clinician or operator of theinstrument10 may articulate theend effector12 relative to theshaft8 by utilizing thearticulation control16, as described in more detail in published U.S. Patent Application Pub. No. 2007/0158385 A1, entitled “Surgical Instrument Having An Articulating End Effector,” by Geoffrey C. Hueil et al., now U.S. Pat. No. 7,670,334, which is incorporated herein by reference.
Theend effector12 includes in this example, among other things, astaple channel22 and a pivotally translatable clamping member, such as ananvil24, which are maintained at a spacing that assures effective stapling and severing of tissue clamped in theend effector12. Thehandle6 includes apistol grip26 towards which aclosure trigger18 is pivotally drawn by the clinician to cause clamping or closing of theanvil24 toward thestaple channel22 of theend effector12 to thereby clamp tissue positioned between theanvil24 andchannel22. The firingtrigger20 is farther outboard of theclosure trigger18. Once theclosure trigger18 is locked in the closure position as further described below, the firingtrigger20 may rotate slightly toward thepistol grip26 so that it can be reached by the operator using one hand. Then the operator may pivotally draw the firingtrigger20 toward thepistol grip12 to cause the stapling and severing of clamped tissue in theend effector12. In other embodiments, different types of clamping members besides theanvil24 could be used, such as, for example, an opposing jaw, etc.
It will be appreciated that the terms “proximal” and “distal” are used herein with reference to a clinician gripping thehandle6 of aninstrument10. Thus, theend effector12 is distal with respect to the moreproximal handle6. It will be further appreciated that, for convenience and clarity, spatial terms such as “vertical” and “horizontal” are used herein with respect to the drawings. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and absolute.
Theclosure trigger18 may be actuated first. Once the clinician is satisfied with the positioning of theend effector12, the clinician may draw back theclosure trigger18 to its fully closed, locked position proximate to thepistol grip26. The firingtrigger20 may then be actuated. The firingtrigger20 returns to the open position (shown inFIGS. 1 and 2) when the clinician removes pressure, as described more fully below. A release button on thehandle6, when depressed may release the lockedclosure trigger18. The release button may be implemented in various forms such as, for example, as aslide release button160 shown inFIG. 7 or any of the mechanisms described in published U.S. Patent Application Publication No. 2007/0175955 A1, which is incorporated herein by reference.
FIG. 3 is an exploded view of theend effector12 according to various embodiments. As shown in the illustrated embodiment, theend effector12 may include, in addition to the previously mentionedchannel22 andanvil24, a cuttinginstrument32, asled33, astaple cartridge34 that is removably seated in thechannel22, and ahelical screw shaft36. The cuttinginstrument32 may be, for example, a knife. Theanvil24 may be pivotably opened and closed at apivot point25 connected to the proximate end of thechannel22. Theanvil24 may also include atab27 at its proximate end that is inserted into a component of the mechanical closure system (described further below) to open and close theanvil24. When theclosure trigger18 is actuated, that is, drawn in by a user of theinstrument10, theanvil24 may pivot about thepivot point25 into the clamped or closed position. If clamping of theend effector12 is satisfactory, the operator may actuate the firingtrigger20, which, as explained in more detail below, causes theknife32 andsled33 to travel longitudinally along thechannel22, thereby cutting tissue clamped within theend effector12. The movement of thesled33 along thechannel22 causes the staples of thestaple cartridge34 to be driven through the severed tissue and against theclosed anvil24, which turns the staples to fasten the severed tissue. In various embodiments, thesled33 may be an integral component of thecartridge34. U.S. Pat. No. 6,978,921, entitled “Surgical Stapling Instrument Incorporating an E-beam Firing Mechanism,” which is incorporated herein by reference, provides more details about such two-stroke cutting and fastening instruments. Thesled33 may be part of thecartridge34, such that when theknife32 retracts following the cutting operation, thesled33 does not retract.
It should be noted that although the embodiments of theinstrument10 described herein employ anend effector12 that staples the severed tissue, in other embodiments different techniques for fastening or sealing the severed tissue may be used. For example, end effectors that use RF energy or adhesives to fasten the severed tissue may also be used. U.S. Pat. No. 5,709,680 entitled “Electrosurgical Hemostatic Device” to Yates et al., and U.S. Pat. No. 5,688,270 entitled “Electrosurgical Hemostatic Device with Recessed and/or Offset Electrodes” to Yates et al., which are incorporated herein by reference, disclose an endoscopic cutting instrument that uses RF energy to seal the severed tissue. Published U.S. Patent Application Publication No. 2007/0102453 A1 to Jerome R. Morgan et al., now U.S. Pat. No. 7,673,783, and published U.S. Patent Application Publication No. 2007/0102452 A1 to Frederick E. Shelton, IV et al., now U.S. Pat. No. 7,607,557, which are also incorporated herein by reference, disclose endoscopic cutting instruments that use adhesives to fasten the severed tissue. Accordingly, although the description herein refers to cutting/stapling operations and the like below, it should be recognized that this is an exemplary embodiment and is not meant to be limiting. Other tissue-fastening techniques may also be used.
FIGS. 4 and 5 are exploded views andFIG. 6 is a side view of theend effector12 andshaft8 according to various embodiments. As shown in the illustrated embodiment, theshaft8 may include aproximate closure tube40 and adistal closure tube42 pivotably linked by a pivot links44. Thedistal closure tube42 includes anopening45 into which thetab27 on theanvil24 is inserted in order to open and close theanvil24, as further described below. Disposed inside theclosure tubes40,42 may be aproximate spine tube46. Disposed inside theproximate spine tube46 may be a main rotational (or proximate) driveshaft48 that communicates with a secondary (or distal) driveshaft50 via a bevel gear assembly52. Thesecondary drive shaft50 is connected to adrive gear54 that engages aproximate drive gear56 of thehelical screw shaft36. Thevertical bevel gear52bmay sit and pivot in an opening57 in the distal end of theproximate spine tube46. Adistal spine tube58 may be used to enclose thesecondary drive shaft50 and the drive gears54,56. Collectively, themain drive shaft48, thesecondary drive shaft50, and the articulation assembly (e.g., the bevel gear assembly52a-c) are sometimes referred to herein as the “main drive shaft assembly.”
Abearing38, positioned at a distal end of thestaple channel22, receives thehelical drive screw36, allowing thehelical drive screw36 to freely rotate with respect to thechannel22. Thehelical screw shaft36 may interface a threaded opening (not shown) of theknife32 such that rotation of theshaft36 causes theknife32 to translate distally or proximately (depending on the direction of the rotation) through thestaple channel22. Accordingly, when themain drive shaft48 is caused to rotate by actuation of the firing trigger20 (as explained in more detail below), the bevel gear assembly52a-ccauses thesecondary drive shaft50 to rotate, which in turn, because of the engagement of the drive gears54,56, causes thehelical screw shaft36 to rotate, which causes theknife driving member32 to travel longitudinally along thechannel22 to cut any tissue clamped within the end effector. Thesled33 may be made of, for example, plastic, and may have a sloped distal surface. As thesled33 traverses thechannel22, the sloped forward surface may push up or drive the staples in the staple cartridge through the clamped tissue and against theanvil24. Theanvil24 turns the staples, thereby stapling the severed tissue. When theknife32 is retracted, theknife32 andsled33 may become disengaged, thereby leaving thesled33 at the distal end of thechannel22.
FIGS. 7-10 illustrate an exemplary embodiment of a motor-driven endocutter. The illustrated embodiment provides user-feedback regarding the deployment and loading force of the cutting instrument in the end effector. In addition, the embodiment may use power provided by the user in retracting the firingtrigger20 to power the device (a so-called “power assist” mode). As shown in the illustrated embodiment, thehandle6 includes exteriorlower sidepieces59,60 and exteriorupper side pieces61,62 that fit together to form, in general, the exterior of thehandle6. Abattery64, such as a Li ion battery, may be provided in thepistol grip portion26 of thehandle6. Thebattery64 powers anelectric motor65 disposed in an upper portion of thepistol grip portion26 of thehandle6. According to various embodiments, a number of battery cells connected in series may be used to power themotor65.
Themotor65 may be a brushed driving motor having a maximum rotation of approximately 25,000 RPM with no load. In other embodiments, themotor65 may include a brushless motor, a cordless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. Themotor64 may drive a 90°bevel gear assembly66 comprising afirst bevel gear68 and asecond bevel gear70. Thebevel gear assembly66 may drive aplanetary gear assembly72. Theplanetary gear assembly72 may include apinion gear74 connected to adrive shaft76. Thepinion gear74 may drive amating ring gear78 that drives ahelical gear drum80 via adrive shaft82. Aring84 may be threaded on thehelical gear drum80. Thus, when themotor65 rotates, thering84 is caused to travel along thehelical gear drum80 by means of the interposedbevel gear assembly66,planetary gear assembly72, andring gear78.
Thehandle6 may also include arun motor sensor110 in communication with the firingtrigger20 to detect when the firingtrigger20 has been drawn in (or “closed”) toward thepistol grip portion26 of thehandle6 by the operator to thereby actuate the cutting/stapling operation by theend effector12. Thesensor110 may be a proportional sensor such as, for example, a rheostat, or variable resistor. When the firingtrigger20 is drawn in, thesensor110 detects the movement, and sends an electrical signal indicative of the voltage (or power) to be supplied to themotor65. When thesensor110 is a variable resistor or the like, the rotation of themotor65 may be generally proportional to the amount of movement of the firingtrigger20. That is, if the operator only draws or closes the firingtrigger20 in a little bit, the rotation of themotor65 is relatively low. When the firingtrigger20 is fully drawn in (or in the fully closed position), the rotation of themotor65 is at its maximum. In other words, the harder the user pulls on the firingtrigger20, the more voltage is applied to themotor65, causing greater rates of rotation.
Thehandle6 may include amiddle handle piece104 adjacent to the upper portion of the firingtrigger20. Thehandle6 also may comprise abias spring112 connected between posts on themiddle handle piece104 and the firingtrigger20. Thebias spring112 may bias the firingtrigger20 to its fully open position. In that way, when the operator releases the firingtrigger20, thebias spring112 will pull the firingtrigger20 to its open position, thereby removing actuation of thesensor110, thereby stopping rotation of themotor65. Moreover, by virtue of thebias spring112, any time a user closes the firingtrigger20, the user will experience resistance to the closing operation, thereby providing the user with feedback as to the amount of rotation exerted by themotor65. Further, the operator could stop retracting the firingtrigger20 to remove thereby force from thesensor100, to thereby stop themotor65. As such, the user may stop the deployment of theend effector12, thereby providing a measure of control of the cutting/fastening operation to the operator.
The distal end of thehelical gear drum80 includes adistal drive shaft120 that drives aring gear122, which mates with apinion gear124. Thepinion gear124 is connected to themain drive shaft48 of the main drive shaft assembly. In that way, rotation of themotor65 causes the main drive shaft assembly to rotate, which causes actuation of theend effector12, as described above.
Thering84 threaded on thehelical gear drum80 may include apost86 that is disposed within aslot88 of a slottedarm90. The slottedarm90 has anopening92 itsopposite end94 that receives apivot pin96 that is connected between the handleexterior side pieces59,60. Thepivot pin96 is also disposed through anopening100 in the firingtrigger20 and anopening102 in themiddle handle piece104.
In addition, thehandle6 may include a reverse motor (or end-of-stroke sensor)130 and a stop motor (or beginning-of-stroke)sensor142. In various embodiments, thereverse motor sensor130 may be a limit switch located at the distal end of thehelical gear drum80 such that thering84 threaded on thehelical gear drum80 contacts and trips thereverse motor sensor130 when thering84 reaches the distal end of thehelical gear drum80. Thereverse motor sensor130, when activated, sends a signal to themotor65 to reverse its rotation direction, thereby withdrawing theknife32 of theend effector12 following the cutting operation. Thestop motor sensor142 may be, for example, a normally closed limit switch. In various embodiments, it may be located at the proximate end of thehelical gear drum80 so that thering84 trips theswitch142 when thering84 reaches the proximate end of thehelical gear drum80.
In operation, when an operator of theinstrument10 pulls back the firingtrigger20, thesensor110 detects the deployment of the firingtrigger20 and sends a signal to themotor65 to cause forward rotation of themotor65 at, for example, a rate proportional to how hard the operator pulls back the firingtrigger20. The forward rotation of themotor65 in turn causes thering gear78 at the distal end of theplanetary gear assembly72 to rotate, thereby causing thehelical gear drum80 to rotate, causing thering84 threaded on thehelical gear drum80 to travel distally along thehelical gear drum80. The rotation of thehelical gear drum80 also drives the main drive shaft assembly as described above, which in turn causes deployment of theknife32 in theend effector12. That is, theknife32 andsled33 are caused to traverse thechannel22 longitudinally, thereby cutting tissue clamped in theend effector12. Also, the stapling operation of theend effector12 is caused to happen in embodiments where a stapling-type end effector is used.
By the time the cutting/stapling operation of theend effector12 is complete, thering84 on thehelical gear drum80 will have reached the distal end of thehelical gear drum80, thereby causing thereverse motor sensor130 to be tripped, which sends a signal to themotor65 to cause themotor65 to reverse its rotation. This in turn causes theknife32 to retract, and also causes thering84 on thehelical gear drum80 to move back to the proximate end of thehelical gear drum80.
Themiddle handle piece104 includes abackside shoulder106 that engages the slottedarm90 as best shown inFIGS. 8 and 9. Themiddle handle piece104 also has a forward motion stop107 that engages the firingtrigger20. The movement of the slottedarm90 is controlled, as explained above, by rotation of themotor65. When the slottedarm90 rotates CCW as thering84 travels from the proximate end of thehelical gear drum80 to the distal end, themiddle handle piece104 will be free to rotate CCW. Thus, as the user draws in the firingtrigger20, the firingtrigger20 will engage the forward motion stop107 of themiddle handle piece104, causing themiddle handle piece104 to rotate CCW. Due to thebackside shoulder106 engaging the slottedarm90, however, themiddle handle piece104 will only be able to rotate CCW as far as the slottedarm90 permits. In that way, if themotor65 should stop rotating for some reason, the slottedarm90 will stop rotating, and the user will not be able to further draw in the firingtrigger20 because themiddle handle piece104 will not be free to rotate CCW due to the slottedarm90.
Components of an exemplary closure system for closing (or clamping) theanvil24 of theend effector12 by retracting theclosure trigger18 are also shown inFIGS. 7-10. In the illustrated embodiment, the closure system includes ayoke250 connected to theclosure trigger18 by a pin251 that is inserted through aligned openings in both theclosure trigger18 and theyoke250. Apivot pin252, about which theclosure trigger18 pivots, is inserted through another opening in theclosure trigger18 which is offset from where the pin251 is inserted through theclosure trigger18. Thus, retraction of theclosure trigger18 causes the upper part of theclosure trigger18, to which theyoke250 is attached via the pin251, to rotate CCW. The distal end of theyoke250 is connected, via apin254, to afirst closure bracket256. Thefirst closure bracket256 connects to asecond closure bracket258. Collectively, theclosure brackets256,258 define an opening in which the proximate end of the proximate closure tube40 (seeFIG. 4) is seated and held such that longitudinal movement of theclosure brackets256,258 causes longitudinal motion by theproximate closure tube40. Theinstrument10 also includes aclosure rod260 disposed inside theproximate closure tube40. Theclosure rod260 may include a window261 into which apost263 on one of the handle exterior pieces, such as exteriorlower sidepiece59 in the illustrated embodiment, is disposed to fixedly connect theclosure rod260 to thehandle6. In that way, theproximate closure tube40 is capable of moving longitudinally relative to theclosure rod260. Theclosure rod260 may also include adistal collar267 that fits into acavity269 inproximate spine tube46 and is retained therein by a cap271 (seeFIG. 4).
In operation, when theyoke250 rotates due to retraction of theclosure trigger18, theclosure brackets256,258 cause theproximate closure tube40 to move distally (i.e., away from the handle end of the instrument10), which causes thedistal closure tube42 to move distally, which causes theanvil24 to rotate about thepivot point25 into the clamped or closed position. When theclosure trigger18 is unlocked from the locked position, theproximate closure tube40 is caused to slide proximately, which causes thedistal closure tube42 to slide proximately, which, by virtue of thetab27 being inserted in thewindow45 of thedistal closure tube42, causes theanvil24 to pivot about thepivot point25 into the open or unclamped position. In that way, by retracting and locking theclosure trigger18, an operator may clamp tissue between theanvil24 andchannel22, and may unclamp the tissue following the cutting/stapling operation by unlocking theclosure trigger20 from the locked position.
Additional configurations for motorized surgical instruments are disclosed in published U.S. Patent Application Publication No. 2007/0175962 A1, entitled “Motor-Driven Surgical Cutting And Fastening Instrument With Tactile Position Feedback,” now U.S. Pat. No. 7,422,139, which is incorporated herein by reference in its entirety.
FIG. 11 is a schematic diagram of the motor control circuit according to various embodiments of the present invention. In various embodiments, the motor control circuit may include one of more integrated circuits (ICs), such as, for example, a processor, memory, microcontroller, time circuits, etc. In other embodiments, the motor control circuit may not comprise any ICs. Such a non-IC motor control circuit may be advantageous because it is often difficult, complicated, and expensive to sterilize a surgical instrument including ICs.
When an operator initially pulls in the firingtrigger20 after locking theclosure trigger18, thesensor110 is activated (or closed, where thesensor110 is a switch), allowing current to flow therethrough. If the normally open reversemotor sensor switch130 is open (meaning the end of the end effector stroke has not been reached), current will flow to a single pole,double throw relay132. When the reversemotor sensor switch130 is not closed, acoil134 of therelay132 will not be energized, so therelay132 will be in its de-energized state.
As shown inFIG. 11, the circuit may also include aresistive element144 and aswitch146 connected in parallel, with the paralleled elements connected in series with therelay132. Theresistive element144 and theswitch146 are also connected to thepower source64. Theswitch146 may be controlled by a control circuit148 that is responsive to the cuttinginstrument position sensor150. According to various embodiments, the control circuit148 may open theswitch146 when the cuttinginstrument32 is (i) very near to the beginning of its stroke and (ii) very near to the end of its stroke. For example, the control circuit may open the switch when the cuttinginstrument32 is (i) 0.001 inches from the beginning point of its stroke and (ii) 0.001 inches from the end of its stroke, as determined by the cuttinginstrument position sensor150. With theswitch146 open, current flows through theresistive element144, and then through therelay132, therelay138, the runmotor sensor switch110, to themotor65. Current flowing through theresistive element144 reduces the magnitude of the current delivered to themotor65, thereby reducing the power delivered by themotor65. Thus, when the cuttinginstrument32 is (i) very near to the beginning of its stroke or (ii) very near to the end of its stroke, the power delivered by themotor65 is reduced. Conversely, once the cuttinginstrument32 moves sufficiently far from its beginning point or end of stroke point, the control circuit148 may close theswitch146, thereby shorting theresistive element144, thereby increasing the current to themotor65, thereby increasing the power delivered by the motor.
According to various embodiments, the electrical circuit further includes lockout sensor switches136a-dcollectively defining aninterlock circuit137 through which current from therelay132, when de-energized, passes in order for electrical operation of themotor65 to be initiated. Each lockout sensor switch136a-dmay be configured to maintain an open (i.e., non-conductive) switch state or a closed (i.e., conductive) switch state responsive to the presence or absence, respectively, of a corresponding condition. Any of the corresponding conditions, if present when theinstrument10 is fired, may result in an unsatisfactory cutting and stapling operation and/or damage to theinstrument10. Conditions to which the lockout sensor switches136a-dmay respond include, for example, (a) the absence of thestaple cartridge34 in thechannel22, (b) the presence of a spent (e.g., previously fired)staple cartridge34 in thechannel22, and (c) an open (or otherwise insufficiently closed) position of theanvil24 with respect to thechannel22. Other conditions to which the lockout sensor switches136a-dmay respond, such as component wear, may be inferred based upon an accumulated number of firing operations produced by theinstrument10. Accordingly, in various embodiments, if any of these conditions exists, the corresponding lockout sensor switches136a-dmaintain an open switch state, thus preventing passage of the current necessary to initiate operation of themotor65. Passage of current by the lockout sensors136a-dis allowed, in various embodiments, only after all of the conditions have been remedied. It will be appreciated that the above-described conditions are provided by way of example only, and that additional lockout sensor switches for responding to other conditions detrimental to operation of theinstrument10 may be provided. It will similarly be appreciated that for embodiments in which one or more of the above-described conditions may not exist or are of no concern, the number of lockout sensor switches may be fewer than that depicted.
As shown inFIG. 11, thelockout sensor switch136amay be implemented using a normally open switch configuration such that a closed switch state is maintained when thestaple cartridge34 is in a position corresponding to its proper receipt by thechannel22. When thestaple cartridge34 is not installed in thechannel22, or is installed improperly (e.g., misaligned), thelockout sensor switch136amaintains an open switch state.Lockout sensor switch136bmay be implemented using a normally open switch configuration such that a closed switch state is maintained only when an unspent staple cartridge34 (i.e., astaple cartridge34 having asled33 in the unfired position) is present in thechannel22. The presence of a spentstaple cartridge34 in thechannel22 causes thelockout sensor switch136bto maintain an open switch state.Lockout sensor switch136cmay be implemented using a normally open switch configuration such that a closed switch state is maintained when theanvil24 is in a closed position with respect to thechannel22. Thelockout sensor switch136cmay be controlled in accordance with a time delay feature wherein a closed switch state is maintained only after theanvil24 is in the closed position for a pre-determined period of time.
Lockout sensor switch136dmay be implemented using a normally closed switch configuration such that a closed switch state is maintained only when an accumulated number of firings produced by theinstrument10 is less than a pre-determined number. Thelockout sensor switch136dmay be in communication with a counter139 configured for maintaining a count representative of the accumulated number of firing operations performed by theinstrument10, comparing the count to the pre-determined number, and controlling the switch state of thelockout sensor switch136dbased upon the comparison. Although shown separately inFIG. 11, it will be appreciated that counter139 may be integral with thelockout sensor switch136dso as to form a common device. Preferably, the counter139 is implemented as an electronic device having an input for incrementing the maintained count based upon the transition of a discrete electrical signal provided thereto. It will be appreciated that a mechanical counter configured for maintaining the count based upon a mechanical input (e.g., retraction of the firing trigger20) may be used instead. When implemented as an electronic device, any discrete signal present in the electrical circuit that transitions once for each firing operation may be utilized for the counter139 input. As shown inFIG. 11, for example, the discrete electrical signal resulting from actuation of the end-of-stroke sensor130 may be utilized. The counter139 may control the switch state oflockout sensor switch136dsuch that a closed switch state is maintained when the maintained count is less than a pre-determined number stored within the counter139. When the maintained count is equal to the pre-determined number, the counter139 causes thelockout sensor switch136dto maintain an open switch state, thus preventing the passage of current therethrough. It will be appreciated that the pre-determined number stored by the counter139 may be selectively adjusted as required. According to various embodiments, the counter304 may be in communication with an external display (not shown), such as an LCD display, integral to theinstrument10 for indicating to a user either the maintained count or the difference between the pre-determined number and the maintained count.
According to various embodiments, theinterlock circuit137 may comprise one or more indicators visible to the user of theinstrument10 for displaying a status of at least one of the lockout sensor switches136a-d. More details regarding such indicators may be found in published U.S. Patent Application Publication No. 2007/0175956, entitled “Electronic Lockouts and Surgical Instrument Including Same,” now U.S. Pat. No. 7,644,848, which is incorporated herein by reference in its entirety. This application also includes example mounting arrangements and configurations for the lockout sensor switches136a-d.
In the illustrated embodiment, when the lockout sensor switches136a-dcollectively maintain a closed switch state, a single pole,single throw relay138 is energized. When therelay138 is energized, current flows through therelay138, through the runmotor switch sensor110, and to themotor65 via a double pole,double throw relay140, thereby powering themotor65, allowing it to rotate in the forward direction. According to various embodiments, because the output of therelay138, once energized, maintains therelay138 in an energized state untilrelay132 is energized, theinterlock circuit137 will not function to prevent operation of the motor165 once initiated, even if one or more of the interlock sensor switches136a-dsubsequently maintains an open switch state. In other embodiments, however, it may be necessary or otherwise desirable to connect theinterlock circuit137 and therelay138 such that one or more the lockout sensor switches136a-dmust maintain a closed switch state in order to sustain operation of the motor165 once initiated.
Rotation of the motor in the forward direction causes thering84 to move distally and thereby de-actuate the stopmotor sensor switch142 in various embodiments. Because theswitch142 is normally closed, asolenoid141 connected to theswitch142 may be energized. Thesolenoid141 may be a conventional push-type solenoid that, when energized, causes a plunger (not shown) to be axially extended. Extension of the plunger may operate to retain theclosure trigger18 in the retracted position, thus preventing theanvil24 from opening while a firing operation is in progress (i.e., while theswitch142 is not actuated). Upon deenergization of thesolenoid141, the plunger is retracted such that manual release of theclosure trigger18 is possible.
When theend effector12 reaches the end of its stroke, thereverse motor sensor130 will be activated, thereby closing theswitch130 and energizing therelay132. This causes therelay132 to assume its energized state (not shown inFIG. 11), which causes current to bypass theinterlock circuit137 and runmotor sensor switch110, and instead causes current to flow to both the normally-closed double pole,double throw relay140 and back to themotor65, but in a manner, via therelay140, that causes themotor65 to reverse its rotational direction. Because the stopmotor sensor switch142 is normally closed, current will flow back to therelay132 to keep it energized until theswitch142 opens. When theknife32 is fully retracted, the stopmotor sensor switch142 is activated, causing theswitch142 to open, thereby removing power from themotor65, and de-energizing thesolenoid141.
In other embodiments, other alternatives may be used to limit the current supplied to themotor65 during certain time periods during the cutting stroke cycle. Other embodiments are described in U.S. patent application Ser. No. 12/235,782, now U.S. Pat. No. 8,210,411, which is incorporated herein by reference in its entirety.
In some instances, it may be advantageous to provide a momentary increase in current to themotor65 to increase the output torque.FIG. 19 shows an embodiment of a circuit for providing a momentary increase to themotor65 according to various embodiments. The circuit is similar to that shown inFIG. 11, except that the circuit ofFIG. 19 additionally includes acharge accumulator device1000 connected to thepower source64. Thecharge accumulator device1000 may be any device that can store charge, such as a capacitor. For example, thecharge accumulator device1000 may comprise an ultracapacitor (sometimes called a supercapacitor). When themotor65 is first turned on, such as when theswitch110 is closed due to retraction of the firingtrigger20, the switch S1 may be closed so that thebattery64 can power themotor65 as described above. In addition, the switch S3 may also be closed for only a brief period of time (“the charging period”) to charge thecharge accumulator device1000 via the resistor R1. For example, according to various embodiments, the switch S3 may be closed for one to ten RC time constants, where R is the resistance of the resistor R1 and C is the capacitance of thecharge accumulator device1000.
The charge in thecharge accumulator device1000 may remain unused during normal operating conditions, but if there comes a time in the procedure where the clinician needs additional output torque from themotor65, thecharge accumulator device1000 could be put in series with thebattery64. This could be done, for example, by opening switch S1 and closing switch S2 (with S3 remaining open following the charging period). With switch S2 closed, thecharge accumulator device1000 would be connected in series with thebattery64, thereby supplying additional current to themotor65.
The condition requiring thecharge accumulator device1000 may be detected in numerous ways. For example, there may be a variable resistor or spring connected to the firingtrigger20. When the firing trigger is retracted beyond a certain point or with a force above a threshold level, thecharge accumulator device1000 may be connected in series to thebattery64. Additionally or alternatively, thehandle6 may comprise an external switch (not shown) that the clinician could activate to connect thecharge accumulator device1000 in series withbattery64.
Thecharge accumulator device1000 could be used with or without the current limiting devices described above in connection withFIG. 11.
At some times during use of theinstrument10, it may be advantageous to have themotor65 run at high speed but relatively low torque output. At other times, it may be desirable to have themotor65 have a high torque output but at low speeds. According to various embodiments, this functionality may be accomplished with amotor65 having multiple (e.g., two or more) windings, as shown inFIG. 20. In the illustrated embodiment, the motor has two windings. A first winding1200 may have winding halves (or portions)1201 and1202. A second winding1204 may have winding halves (or portions)1206 and1208. Themotor65 in this example may be a 6 or 8 lead motor with a bipolar driving circuit1210 (seeFIGS. 11 and 12, for example). When the high-speed low-torque mode is desired, the two sets of winding may be connected in series. In this mode, as shown inFIG. 20, switches S1 and S4 are closed, and switches S2, S3, S5, and S6 are open. When the low-speed high-torque mode is desired, the two sets of windings may be connected in parallel. In this mode, switches S1 and S4 are open, and switches S2, S3, S5, and S6 are closed. The ability to transition between the two modes effectively creates a two-speed transmission with no additional moving parts. It also allows the same motor to generate both high speeds and high torque outputs, albeit not at the same time. An advantage of this configuration is that it avoids using multiple motors. In addition, it may be possible to eliminate some gearing because themotor65 can generate extra torque when in the parallel mode and extra speed when in the series mode. In addition, additional windings could be employed such that a greater number of operating modes may be realized. For example, there could be windings for multiple combinations of series and parallel winding connections. Also, some windings may be used for sensing motor conditions, etc.
According to various embodiments, thehandle6 may comprise an external motormode selection switch1220, as shown inFIG. 21. By using theswitch1220, the operator of theinstrument10 could select with themotor65 is in the high-speed low-torque mode or in the low-speed high-torque mode. Other switching circuits could also be used to toggle themotor65 between the operating modes, such as switching circuits that automatically switch the motor mode based on sensor inputs.
In a motorized surgical instrument, such as one of the motorized endoscopic instruments described above or in a motorized circular cutter instrument, the motor may be powered by a number of battery cells connected in series. Further, it may be desirable in certain circumstances to power the motor with some fraction of the total number of battery cells. For example, as shown inFIG. 12, themotor65 may be powered by apower pack299 comprising six (6)battery cells310 connected in series. Thebattery cells310 may be, for example, 3-volt lithium battery cells, such as CR123A battery cells, although in other embodiments, different types of battery cells could be used (including battery cells with different voltage levels and/or different chemistries). If six 3-volt battery cells310 were connected in series to power themotor65, the total voltage available to power themotor65 would be 18 volts. Thebattery cells310 may comprise rechargeable or non-rechargeable battery cells.
In such an embodiment, under the heaviest loads, the input voltage to themotor65 may sag to about nine to ten volts. At this operating condition, thepower pack299 is delivering maximum power to themotor65. Accordingly, as shown inFIG. 12, the circuit may include aswitch312 that selectively allows themotor65 to be powered by either (1) all of thebattery cells310 or (2) a fraction of thebattery cells310. As shown inFIG. 12, by proper selection, theswitch312 may allow themotor65 to be powered by all six battery cells or four of the battery cells. That way, theswitch312 could be used to power themotor65 with either 18 volts (when using all six battery cells310) or 12 volts (such using four of the second battery cells). In various embodiments, the design choice for the number of battery cells in the fraction that is used to power themotor65 may be based on the voltage required by themotor65 when operating at maximum output for the heaviest loads.
Theswitch312 may be, for example, an electromechanical switch, such as a micro switch. In other embodiments, theswitch312 may be implemented with a solid-state switch, such as transistor. Asecond switch314, such as a push button switch, may be used to control whether power is applied to themotor65 at all. Also, a forward/reverse switch316 may be used to control whether themotor65 rotates in the forward direction or the reverse direction. The forward/reverse switch316 may be implemented with a double pole—double throw switch, such as therelay140 shown inFIG. 11.
In operation, the user of theinstrument10 could select the desired power level by using some sort of switch control, such as a position-dependent switch (not shown), such as a toggle switch, a mechanical lever switch, or a cam, which controls the position of theswitch312. Then the user may activate thesecond switch314 to connect the selectedbattery cells310 to themotor65. In addition, the circuit shown inFIG. 12 could be used to power the motor of other types of motorized surgical instruments, such as circular cutters and/or laparoscopic instruments. More details regarding circular cutters may be found in published U.S. Patent Application Publication Nos. 2006/0047307 A1 and 2007/0262116 A1, now U.S. Pat. Nos. 8,217,074 and 7,500,979, which are incorporated herein by reference.
In other embodiments, as shown inFIG. 13, aprimary power source340, such as a battery cell, such as a CR2 or CR123A battery cell, may be used to charge a number ofsecondary accumulator devices342. Theprimary power source340 may comprise one or a number of series-connected battery cells, which are preferably replaceable in the illustrated embodiment. Thesecondary accumulator devices342 may comprise, for example, rechargeable battery cells and/or supercapacitors (also known as “ultracapacitors” or “electrochemical double layer capacitors” (EDLC)). Supercapacitors are electrochemical capacitors that have an unusually high energy density when compared to common electrolytic capacitors, typically on the order of thousands of times greater than a high-capacity electrolytic capacitor.
Theprimary power source340 may charge thesecondary accumulator devices342. Once sufficiently charged, theprimary power source340 may be removed and thesecondary accumulator devices342 may be used to power themotor65 during a procedure or operation. The accumulatingdevices342 may take about fifteen to thirty minutes to charge in various circumstances. Supercapacitors have the characteristic they can charge and discharge extremely rapidly in comparison to conventional batteries. In addition, whereas batteries are good for only a limited number of charge/discharge cycles, supercapacitors can often be charged/discharged repeatedly, sometimes for tens of millions of cycles. For embodiments using supercapacitors as thesecondary accumulator devices342, the supercapacitors may comprise carbon nanotubes, conductive polymers (e.g., polyacenes), or carbon aerogels.
As shown inFIG. 14, acharge management circuit344 could be employed to determine when thesecondary accumulator devices342 are sufficiently charged. Thecharge management circuit344 may include an indicator, such as one or more LEDs, an LCD display, etc., that is activated to alert a user of theinstrument10 when thesecondary accumulator devices342 are sufficiently charged.
Theprimary power source340, thesecondary accumulator devices342, and thecharge management circuit344 may be part of a power pack in thepistol grip portion26 of thehandle6 of theinstrument10, or in another part of theinstrument10. The power pack may be removable from thepistol grip portion26, in which case, when theinstrument10 is to be used for surgery, the power pack may be inserted aseptically into the pistol grip portion26 (or other position in the instrument according to other embodiments) by, for example, a circulating nurse assisting in the surgery. After insertion of the power pack, the nurse could put the replaceableprimary power source340 in the power pack to charge up the secondary accumulator devices342 a certain time period prior to use of theinstrument10, such as thirty minutes. When thesecondary accumulator devices342 are charged, thecharge management circuit344 may indicate that the power pack is ready for use. At this point, the replaceableprimary power source340 may be removed. During the operation, the user of theinstrument10 may then activate themotor65, such as by activating theswitch314, whereby thesecondary accumulator devices342 power themotor65. Thus, instead of having a number of disposable batteries to power themotor65, one disposable battery (as the primary power source340) could be used in such an embodiment, and thesecondary accumulator devices342 could be reusable. In alternative embodiments, however, it should be noted that thesecondary accumulator devices342 could be non-rechargeable and/or non-reusable. Thesecondary accumulators342 may be used with thecell selection switch312 described above in connection withFIG. 12.
Thecharge management circuit344 may also include indicators (e.g., LEDs or LCD display) that indicate how much charge remains in thesecondary accumulator devices342. That way, the surgeon (or other user of the instrument10) can see how much charge remains through the course of the procedure involving theinstrument10.
Thecharge management circuit344, as shown inFIG. 15, may comprise acharge meter345 for measuring the charge across thesecondary accumulators342. Thecharge management circuit344 also may comprise anon-volatile memory346, such as flash or ROM memory, and one ormore processors348. The processor(s)348 may be connected to thememory346 to control the memory. In addition, the processor(s)348 may be connected to thecharge meter345 to read the readings of and otherwise control thecharge meter345. Additionally, the processor(s)348 may control the LEDs or other output devices of thecharge management circuit344. The processor(s)348 can store parameters of theinstrument10 in thememory346. The parameters may include operating parameters of the instrument that are sensed by various sensors that may be installed or employed in theinstrument10, such as, for example, the number of firings, the levels of forces involved, the distance of the compression gap between the opposing jaws of theend effector12, the amount of articulation, etc. Additionally, the parameters stored in thememory346 may comprise ID values for various components of theinstrument10 that thecharge management circuit344 may read and store. The components having such IDs may be replaceable components, such as thestaple cartridge34. The IDs may be for example, RFIDs that thecharge management circuit344 reads via aRFID transponder350. TheRFID transponder350 may read RFIDs from components of the instrument, such as thestaple cartridge34, that include RFID tags. The ID values may be read, stored in thememory346, and compared by theprocessor348 to a list of acceptable ID values stored in thememory346 or another store associated with the charge management circuit, to determine, for example, if the removable/replaceable component associated with the read ID value is authentic and/or proper. According to various embodiments, if theprocessor348 determines that the removable/replaceable component associated with the read ID value is not authentic, thecharge management circuit344 may prevent use of the power pack by theinstrument10, such as by opening a switch (not shown) that would prevent power from the power pack being delivered to themotor65. According to various embodiments, various parameters that theprocessor348 may evaluate to determine whether the component is authentic and/or proper include: date code; component model/type; manufacturer; regional information; and previous error codes.
Thecharge management circuit344 may also comprise an i/o interface352 for communicating with another device, such as described below. That way, the parameters stored in thememory346 may be downloaded to another device. The i/o interface352 may be, for example, a wired or wireless interface.
As mentioned before, the power pack may comprise thesecondary accumulators342, thecharge management circuit344, and/or the f/r switch316. According to various embodiments, as shown inFIG. 16, thepower pack299 could be connected to acharger base362, which may, among other things, charge thesecondary accumulators342 in the power pack. Thecharger base362 could be connected to thepower pack299 by connecting aseptically thecharger base362 to thepower pack299 while the power pack is installed in theinstrument10. In other embodiments where the power pack is removable, thecharger base362 could be connected to thepower pack299 by removing thepower pack299 from theinstrument10 and connecting it to thecharger base362. For such embodiments, after thecharger base362 sufficiently charges thesecondary accumulators342, thepower pack299 may be aseptically installed in theinstrument10.
As shown inFIG. 16, thecharger base362 may comprise apower source364 for charging thesecondary accumulators342. Thepower source364 of thecharger base362 may be, for example, a battery (or a number of series-connected batteries), or an AC/DC converter that converters AC power, such as from electrical power mains, to DC, or any other suitable power source for charging thesecondary accumulators342. Thecharger base362 may also comprise indicator devices, such as LEDs, a LCD display, etc., to show the charge status of thesecondary accumulators342.
In addition, as shown inFIG. 16, thecharger base362 may comprise one ormore processors366, one ormore memory units368, and i/o interfaces370,372. Through the first i/o interface370, thecharger base362 may communicate with the power pack299 (via the power pack's i/o interface352). That way, for example, data stored in thememory346 of thepower pack299 may be downloaded to thememory368 of thecharger base362. In that way, theprocessor366 can evaluate the ID values for the removable/replaceable components, downloaded from thecharge management circuit344, to determine the authenticity and suitability of the components. The operating parameters downloaded from thecharge management circuit344 may also stored in thememory368, and then may then be downloaded to another computer device via the second i/o interface372 for evaluation and analysis, such as by the hospital system in which the operation involving theinstrument10 is performed, by the office of the surgeon, by the distributor of the instrument, by the manufacturer of the instrument, etc.
Thecharger base362 may also comprise acharge meter374 for measuring the charge across thesecondary accumulators342. Thecharge meter374 may be in communication with the processor(s)366, so that the processor(s)366 can determine in real-time the suitability of thepower pack299 for use to ensure high performance.
In another embodiment, as shown inFIG. 17, the battery circuit may comprise apower regulator320 to control the power supplied by thepower savers310 to themotor65. Thepower regulator320 may also be part of thepower pack299, or it may be a separate component. As mentioned above, themotor65 may be a brushed motor. The speed of brushed motors generally is proportional to the applied input voltage. Thepower regulator320 may provide a highly regulated output voltage to themotor65 so that themotor65 will operate at a constant (or substantially constant) speed. According to various embodiments, thepower regulator320 may comprise a switch-mode power converter, such as a buck-boost converter, as shown in the example ofFIG. 17. Such a buck-boost converter320 may comprise apower switch322, such as a FET, arectifier32, aninductor326, and acapacitor328. When thepower switch322 is on, the input voltage source (e.g., the power sources310) is directly connected to theinductor326, which stores energy in this state. In this state, thecapacitor328 supplies energy to the output load (e.g., the motor65). When thepower switch320 is in the off state, theinductor326 is connected to the output load (e.g., the motor65) and thecapacitor328, so energy is transferred from theinductor326 to thecapacitor328 and theload65. Acontrol circuit330 may control thepower switch322. Thecontrol circuit330 may employ digital and/or analog control loops. In addition, in other embodiments, thecontrol circuit330 may receive control information from a master controller (not shown) via a communication link, such as a serial or parallel digital data bus. The voltage set point for the output of thepower regulator320 may be set, for example, to one-half of the open circuit voltage, at which point the maximum power available from the source is available.
In other embodiments, different power converter topologies may be employed, including linear or switch-mode power converters. Other switch-mode topologies that may be employed include a flyback, forward, buck, boost, and SEPIC. The set point voltage for thepower regulator320 could be changed depending on how many of the battery cells are being used to power themotor65. Additionally, thepower regulator320 could be used with thesecondary accumulator devices342 shown inFIG. 13. Further, the forward-reverse switch316 could be incorporated into thepower regulator320, although it is shown separately inFIG. 17.
Batteries can typically be modeled as an ideal voltage source and a source resistance. For an ideal model, when the source and load resistance are matched, maximum power is transferred to the load.FIG. 18 shows a typical power curve for a battery. When the battery circuit is open, the voltage across the battery is high (at its open circuit value) and the current drawn from the battery is zero. The power delivered from the battery is zero also. As more current is drawn from the battery, the voltage across the battery decreases. The power delivered by the battery is the product of the current and the voltage. The power reaches its peak around at a voltage level that is less than the open circuit voltage. As shown inFIG. 18, with most battery chemistries there is a sharp drop in the voltage/power at higher current because of the chemistry or positive temperature coefficient (PTC), or because of a battery protection device.
Particularly for embodiments using a battery (or batteries) to power themotor65 during a procedure, thecontrol circuit330 can monitor the output voltage and control the set point of theregulator320 so that the battery operates on the “left” or power-increasing side of the power curve. If the battery reaches the peak power level, thecontrol circuit330 can change (e.g., lower) the set point of the regulator so that less total power is being demanded from the battery. Themotor65 would then slow down. In this way, the demand from the power pack would rarely if ever exceed the peak available power so that a power-starving situation during a procedure could be avoided.
In addition, according to other embodiments, the power drawn from the battery may be optimized in such a way that the chemical reactions within the battery cells would have time to recover, to thereby optimize the current and power available from the battery. In pulsed loads, batteries typically provide more power at the beginning of the pulse that toward the end of the pulse. This is due to several factors, including: (1) the PTC may be changing its resistance during the pulse; (2) the temperature of the battery may be changing; and (3) the electrochemical reaction rate is changing due to electrolyte at the cathode being depleted and the rate of diffusion of the fresh electrolyte limits the reaction rate. According to various embodiments, thecontrol circuit330 may control theconverter320 so that it draws a lower current from the battery to allow the battery to recover before it is pulsed again.
As mentioned above, according to various embodiments thebattery pack299 may comprisemultiple battery cells310.FIG. 22 shows an embodiment with six (6)battery cells310. Thebattery cells310 may be, for example, lithium primary batteries. According to various embodiments, thebattery pack299 may have only a fraction of the battery cells internally connected. For example, as shown inFIG. 22,cell310ais connected tocell310b,cell310cis connected tocell310d, andcell310eis connected tocell310f. However,cell310bis not connected internally in the battery pack tocell310c, andcell310dis not connected internally in the battery pack tocell310e. Thehandle6 of theinstrument10 in such embodiments may comprise abattery cell connector1300 that connects thecells310 in series only when thebattery pack299 is physically inserted in theinstrument10. For example, theconnector1300 may comprise apositive output terminal1302, aconnector1304 that series connectscell310btocell310c, aconnector1306 that connectscell310dtocell310e, and anegative output terminal1308.
FIG. 23 shows an embodiment of theinstrument10 where a replaceable,removable battery pack299 is installed in thehandle6 of theinstrument10. As shown inFIG. 23, thebattery cell connector1300 may be integrated into thehandle6 such that, when thebattery pack299 is inserted into thehandle6, thebattery cell connector1300 makes the necessary battery cell connections.
Of course, in other embodiments, battery packs with a different number of internal cells and different numbers of internally connected cells may be used. For example,FIG. 24 shows an embodiment with sixcells310a-f, where two sets of three cells (cells310a-candcells310d-f) are connected together.
The devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either case, however, the device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, the device can be disassembled, and any number of the particular pieces or parts of the device can be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, the device can be reassembled for subsequent use either at a reconditioning facility, or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that reconditioning of a device can utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.
Preferably, the various embodiments of the invention described herein will be processed before surgery. First, a new or used instrument is obtained and if necessary cleaned. The instrument can then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a thermoformed plastic shell covered with a sheet of TYVEK. The container and instrument are then placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation kills bacteria on the instrument and in the container. The sterilized instrument can then be stored in the sterile container. The sealed container keeps the instrument sterile until it is opened in the medical facility.
It is preferred that the device is sterilized. This can be done by any number of ways known to those skilled in the art including beta or gamma radiation, ethylene oxide, steam and other methods.
While the present invention has been illustrated by description of several embodiments and while the illustrative embodiments have been described in considerable detail, it is not the intention of the applicant to restrict or in any way limit the scope of the appended claims to such detail. Additional advantages and modifications may readily appear to those skilled in the art. The various embodiments of the present invention represent vast improvements over prior staple methods that require the use of different sizes of staples in a single cartridge to achieve staples that have differing formed (final) heights.
Accordingly, the present invention has been discussed in terms of endoscopic procedures and apparatus. However, use herein of terms such as “endoscopic” should not be construed to limit the present invention to a surgical stapling and severing instrument for use only in conjunction with an endoscopic tube (i.e., trocar). On the contrary, it is believed that the present invention may find use in any procedure where access is limited, including but not limited to laparoscopic procedures, as well as open procedures. Moreover, the unique and novel aspects of the various staple cartridge embodiments of the present invention may find utility when used in connection with other forms of stapling apparatuses without departing from the spirit and scope of the present invention.
Over the years a variety of minimally invasive robotic (or “telesurgical”) systems have been developed to increase surgical dexterity as well as to permit a surgeon to operate on a patient in an intuitive manner. Many of such systems are disclosed in the following U.S. patents which are each herein incorporated by reference in their respective entirety: U.S. Pat. No. 5,792,135, entitled “Articulated Surgical Instrument For Performing Minimally Invasive Surgery With Enhanced Dexterity and Sensitivity”, U.S. Pat. No. 6,231,565, entitled “Robotic Arm DLUS For Performing Surgical Tasks”, U.S. Pat. No. 6,783,524, entitled “Robotic Surgical Tool With Ultrasound Cauterizing and Cutting Instrument”, U.S. Pat. No. 6,364,888, entitled “Alignment of Master and Slave In a Minimally Invasive Surgical Apparatus”, U.S. Pat. No. 7,524,320, entitled “Mechanical Actuator Interface System For Robotic Surgical Tools”, U.S. Pat. No. 7,691,098, entitled Platform Link Wrist Mechanism”, U.S. Pat. No. 7,806,891, entitled “Repositioning and Reorientation of Master/Slave Relationship in Minimally Invasive Telesurgery”, and U.S. Pat. No. 7,824,401, entitled “Surgical tool With Writed Monopolar Electrosurgical End Effectors”. Many of such systems, however, have in the past been unable to generate the magnitude of forces required to effectively cut and fasten tissue.
FIG. 25 depicts one version of amaster controller1001 that may be used in connection with a roboticarm slave cart1100 of the type depicted inFIG. 26.Master controller1001 and roboticarm slave cart1100, as well as their respective components and control systems are collectively referred to herein as arobotic system1000. Examples of such systems and devices are disclosed in U.S. Pat. No. 7,524,320 which has been herein incorporated by reference. Thus, various details of such devices will not be described in detail herein beyond that which may be necessary to understand various embodiments and forms of the present invention. As is known, themaster controller1001 generally includes master controllers (generally represented as1003 inFIG. 25) which are grasped by the surgeon and manipulated in space while the surgeon views the procedure via astereo display1002. Themaster controllers1001 generally comprise manual input devices which preferably move with multiple degrees of freedom, and which often further have an actuatable handle for actuating tools (for example, for closing grasping saws, applying an electrical potential to an electrode, or the like).
As can be seen inFIG. 26, in one form, therobotic arm cart1100 is configured to actuate a plurality of surgical tools, generally designated as1200. Various robotic surgery systems and methods employing master controller and robotic arm cart arrangements are disclosed in U.S. Pat. No. 6,132,368, entitled “Multi-Component Telepresence System and Method”, the full disclosure of which is incorporated herein by reference. In various forms, therobotic arm cart1100 includes a base1002 from which, in the illustrated embodiment, threesurgical tools1200 are supported. In various forms, thesurgical tools1200 are each supported by a series of manually articulatable linkages, generally referred to as set-upjoints1104, and arobotic manipulator1106. These structures are herein illustrated with protective covers extending over much of the robotic linkage. These protective covers may be optional, and may be limited in size or entirely eliminated in some embodiments to minimize the inertia that is encountered by the servo mechanisms used to manipulate such devices, to limit the volume of moving components so as to avoid collisions, and to limit the overall weight of thecart1100.Cart1100 will generally have dimensions suitable for transporting thecart1100 between operating rooms. Thecart1100 may be configured to typically fit through standard operating room doors and onto standard hospital elevators. In various forms, thecart1100 would preferably have a weight and include a wheel (or other transportation) system that allows thecart1100 to be positioned adjacent an operating table by a single attendant.
Referring now toFIG. 27, in at least one form,robotic manipulators1106 may include alinkage1108 that constrains movement of thesurgical tool1200. In various embodiments,linkage1108 includes rigid links coupled together by rotational joints in a parallelogram arrangement so that thesurgical tool1200 rotates around a point inspace1110, as more fully described in issued U.S. Pat. No. 5,817,084, the full disclosure of which is herein incorporated by reference. The parallelogram arrangement constrains rotation to pivoting about anaxis1112a, sometimes called the pitch axis. The links supporting the parallelogram linkage are pivotally mounted to set-up joints1104 (FIG. 26) so that thesurgical tool1200 further rotates about anaxis1112b, sometimes called the yaw axis. The pitch andyaw axes1112a,1112bintersect at theremote center1114, which is aligned along ashaft1208 of thesurgical tool1200. Thesurgical tool1200 may have further degrees of driven freedom as supported bymanipulator1106, including sliding motion of thesurgical tool1200 along the longitudinal tool axis “LT-LT”. As thesurgical tool1200 slides along the tool axis LT-LT relative to manipulator1106 (arrow1112c),remote center1114 remains fixed relative tobase1116 ofmanipulator1106. Hence, the entire manipulator is generally moved to re-positionremote center1114.Linkage1108 ofmanipulator1106 is driven by a series ofmotors1120. These motors actively movelinkage1108 in response to commands from a processor of a control system. As will be discussed in further detail below,motors1120 are also employed to manipulate thesurgical tool1200.
An alternative set-up joint structure is illustrated inFIG. 28. In this embodiment, asurgical tool1200 is supported by analternative manipulator structure1106′ between two tissue manipulation tools. Those of ordinary skill in the art will appreciate that various embodiments of the present invention may incorporate a wide variety of alternative robotic structures, including those described in U.S. Pat. No. 5,878,193, entitled “Automated Endoscope System For Optimal Positioning”, the full disclosure of which is incorporated herein by reference. Additionally, while the data communication between a robotic component and the processor of the robotic surgical system is primarily described herein with reference to communication between thesurgical tool1200 and themaster controller1001, it should be understood that similar communication may take place between circuitry of a manipulator, a set-up joint, an endoscope or other image capture device, or the like, and the processor of the robotic surgical system for component compatibility verification, component-type identification, component calibration (such as off-set or the like) communication, confirmation of coupling of the component to the robotic surgical system, or the like.
An exemplary non-limitingsurgical tool1200 that is well-adapted for use with arobotic system1000 that has a tool drive assembly1010 (FIG. 30) that is operatively coupled to amaster controller1001 that is operable by inputs from an operator (i.e., a surgeon) is depicted inFIG. 29. As can be seen in that Figure, thesurgical tool1200 includes asurgical end effector2012 that comprises an endocutter. In at least one form, thesurgical tool1200 generally includes anelongated shaft assembly2008 that has aproximal closure tube2040 and adistal closure tube2042 that are coupled together by an articulation joint2011. Thesurgical tool1200 is operably coupled to the manipulator by a tool mounting portion, generally designated as1300. Thesurgical tool1200 further includes aninterface1230 which mechanically and electrically couples thetool mounting portion1300 to the manipulator. One form ofinterface1230 is illustrated inFIGS. 27-31. In various embodiments, thetool mounting portion1300 includes atool mounting plate1302 that operably supports a plurality of (four are shown inFIG. 34) rotatable body portions, driven discs orelements1304, that each include a pair ofpins1306 that extend from a surface of the drivenelement1304. Onepin1306 is closer to an axis of rotation of each drivenelements1304 than theother pin1306 on the same drivenelement1304, which helps to ensure positive angular alignment of the drivenelement1304.Interface1230 includes anadaptor portion1240 that is configured to mountingly engage the mountingplate1302 as will be further discussed below. Theadaptor portion1240 may include an array of electrical connecting pins1242 (FIG. 32) which may be coupled to a memory structure by a circuit board within thetool mounting portion1300. Whileinterface1230 is described herein with reference to mechanical, electrical, and magnetic coupling elements, it should be understood that a wide variety of telemetry modalities might be used, including infrared, inductive coupling, or the like.
As can be seen inFIGS. 30-33, theadapter portion1240 generally includes atool side1244 and aholder side1246. In various forms, a plurality ofrotatable bodies1250 are mounted to a floatingplate1248 which has a limited range of movement relative to the surrounding adaptor structure normal to the major surfaces of theadaptor1240. Axial movement of the floatingplate1248 helps decouple therotatable bodies1250 from thetool mounting portion1300 when thelevers1303 along the sides of the tool mountingportion housing1301 are actuated (SeeFIG. 29). Other mechanisms/arrangements may be employed for releasably coupling thetool mounting portion1300 to theadaptor1240. In at least one form,rotatable bodies1250 are resiliently mounted to floatingplate1248 by resilient radial members which extend into a circumferential indentation about therotatable bodies1250. Therotatable bodies1250 can move axially relative toplate1248 by deflection of these resilient structures. When disposed in a first axial position (toward tool side1244) therotatable bodies1250 are free to rotate without angular limitation. However, as therotatable bodies1250 move axially towardtool side1244, tabs1252 (extending radially from the rotatable bodies1250) laterally engage detents on the floating plates so as to limit angular rotation of therotatable bodies1250 about their axes. This limited rotation can be used to help drivingly engage therotatable bodies1250 withdrive pins1272 of a correspondingtool holder portion1270 of therobotic system1000, as the drive pins1272 will push therotatable bodies1250 into the limited rotation position until the pins1234 are aligned with (and slide into)openings1256′.Openings1256 on thetool side1244 andopenings1256′ on theholder side1246 ofrotatable bodies1250 are configured to accurately align the driven elements1304 (FIG. 34) of thetool mounting portion1300 with thedrive elements1271 of thetool holder1270. As described above regarding inner andouter pins1306 of drivenelements1304, theopenings1256,1256′ are at differing distances from the axis of rotation on their respectiverotatable bodies1250 so as to ensure that the alignment is not 180 degrees from its intended position. Additionally, each of theopenings1256 is slightly radially elongated so as to fittingly receive thepins1306 in the circumferential orientation. This allows thepins1306 to slide radially within theopenings1256,1256′ and accommodate some axial misalignment between thetool1200 andtool holder1270, while minimizing any angular misalignment and backlash between the drive and driven elements.Openings1256 on thetool side1244 are offset by about 90 degrees from theopenings1256′ (shown in broken lines) on theholder side1246, as can be seen most clearly inFIG. 33.
Various embodiments may further include an array ofelectrical connector pins1242 located onholder side1246 ofadaptor1240, and thetool side1244 of theadaptor1240 may include slots1258 (FIG. 33) for receiving a pin array (not shown) from thetool mounting portion1300. In addition to transmitting electrical signals between thesurgical tool1200 and thetool holder1270, at least some of these electrical connections may be coupled to an adaptor memory device1260 (FIG. 32) by a circuit board of theadaptor1240.
Adetachable latch arrangement1239 may be employed to releasably affix theadaptor1240 to thetool holder1270. As used herein, the term “tool drive assembly” when used in the context of therobotic system1000, at least encompasses various embodiments of theadapter1240 andtool holder1270 and which has been generally designated as1010 inFIG. 30. For example, as can be seen inFIG. 30, thetool holder1270 may include a firstlatch pin arrangement1274 that is sized to be received incorresponding clevis slots1241 provided in theadaptor1240. In addition, thetool holder1270 may further have second latch pins1276 that are sized to be retained incorresponding latch clevises1243 in theadaptor1240. SeeFIG. 32. In at least one form, alatch assembly1245 is movably supported on theadapter1240 and is biasable between a first latched position wherein the latch pins1276 are retained within theirrespective latch clevis1243 and an unlatched position wherein the second latch pins1276 may be into or removed from thelatch clevises1243. A spring or springs (not shown) are employed to bias the latch assembly into the latched position. A lip on thetool side1244 ofadaptor1240 may slidably receive laterally extending tabs oftool mounting housing1301.
Turning next toFIGS. 34-41, in at least one embodiment, thesurgical tool1200 includes asurgical end effector2012 that comprises in this example, among other things, at least onecomponent2024 that is selectively movable between first and second positions relative to at least oneother component2022 in response to various control motions applied thereto as will be discussed in further detail below. In various embodiments,component2022 comprises anelongated channel2022 configured to operably support asurgical staple cartridge2034 therein andcomponent2024 comprises a pivotally translatable clamping member, such as ananvil2024. Various embodiments of thesurgical end effector2012 are configured to maintain theanvil2024 andelongated channel2022 at a spacing that assures effective stapling and severing of tissue clamped in thesurgical end effector2012. As can be seen inFIG. 40, thesurgical end effector2012 further includes acutting instrument2032 and asled2033. Thecutting instrument2032 may be, for example, a knife. Thesurgical staple cartridge2034 operably houses a plurality of surgical staples (not show) therein that are supported on movable staple drivers (not shown). As thecutting instrument2032 is driven distally through a centrally-disposed slot (not shown) in thesurgical staple cartridge2034, it forces thesled2033 distally as well. As thesled2033 is driven distally, its “wedge-shaped” configuration contacts the movable staple drivers and drives them vertically toward theclosed anvil2024. The surgical staples are formed as they are driven into the forming surface located on the underside of theanvil2024. Thesled2033 may be part of thesurgical staple cartridge2034, such that when thecutting instrument2032 is retracted following the cutting operation, thesled2033 does not retract. Theanvil2024 may be pivotably opened and closed at apivot point2025 located at the proximal end of theelongated channel2022. Theanvil2024 may also include atab2027 at its proximal end that interacts with a component of the mechanical closure system (described further below) to facilitate the opening of theanvil2024. Theelongated channel2022 and theanvil2024 may be made of an electrically conductive material (such as metal) so that they may serve as part of an antenna that communicates with sensor(s) in the end effector, as described above. Thesurgical staple cartridge2034 could be made of a nonconductive material (such as plastic) and the sensor may be connected to or disposed in thesurgical staple cartridge2034, as was also described above.
As can be seen inFIGS. 34-41, thesurgical end effector2012 is attached to thetool mounting portion1300 by anelongated shaft assembly2008 according to various embodiments. As shown in the illustrated embodiment, theshaft assembly2008 includes an articulation joint generally indicated as2011 that enables thesurgical end effector2012 to be selectively articulated about an articulation axis AA-AA that is substantially transverse to a longitudinal tool axis LT-LT. SeeFIG. 35. In other embodiments, the articulation joint is omitted. In various embodiments, theshaft assembly2008 may include aclosure tube assembly2009 that comprises aproximal closure tube2040 and adistal closure tube2042 that are pivotably linked by apivot links2044 and operably supported on a spine assembly generally depicted as2049. In the illustrated embodiment, the spine assembly2049 comprises adistal spine portion2050 that is attached to theelongated channel2022 and is pivotally coupled to theproximal spine portion2052. Theclosure tube assembly2009 is configured to axially slide on the spine assembly2049 in response to actuation motions applied thereto. Thedistal closure tube2042 includes anopening2045 into which thetab2027 on theanvil2024 is inserted in order to facilitate opening of theanvil2024 as thedistal closure tube2042 is moved axially in the proximal direction “PD”. Theclosure tubes2040,2042 may be made of electrically conductive material (such as metal) so that they may serve as part of the antenna, as described above. Components of the main drive shaft assembly (e.g., the drive shafts2048,2050) may be made of a nonconductive material (such as plastic).
In use, it may be desirable to rotate thesurgical end effector2012 about the longitudinal tool axis LT-LT. In at least one embodiment, thetool mounting portion1300 includes arotational transmission assembly2069 that is configured to receive a corresponding rotary output motion from thetool drive assembly1010 of therobotic system1000 and convert that rotary output motion to a rotary control motion for rotating the elongated shaft assembly2008 (and surgical end effector2012) about the longitudinal tool axis LT-LT. In various embodiments, for example, theproximal end2060 of theproximal closure tube2040 is rotatably supported on thetool mounting plate1302 of thetool mounting portion1300 by aforward support cradle1309 and aclosure sled2100 that is also movably supported on thetool mounting plate1302. In at least one form, therotational transmission assembly2069 includes atube gear segment2062 that is formed on (or attached to) theproximal end2060 of theproximal closure tube2040 for operable engagement by arotational gear assembly2070 that is operably supported on thetool mounting plate1302. As can be seen inFIG. 37, therotational gear assembly2070, in at least one embodiment, comprises arotation drive gear2072 that is coupled to a corresponding first one of the driven discs orelements1304 on theadapter side1307 of thetool mounting plate1302 when thetool mounting portion1300 is coupled to thetool drive assembly1010. SeeFIG. 34. Therotational gear assembly2070 further comprises a rotary drivengear2074 that is rotatably supported on thetool mounting plate1302 in meshing engagement with thetube gear segment2062 and therotation drive gear2072. Application of a first rotary output motion from thetool drive assembly1010 of therobotic system1000 to the corresponding drivenelement1304 will thereby cause rotation of therotation drive gear2072. Rotation of therotation drive gear2072 ultimately results in the rotation of the elongated shaft assembly2008 (and the surgical end effector2012) about the longitudinal tool axis LT-LT (represented by arrow “R” inFIG. 37). It will be appreciated that the application of a rotary output motion from thetool drive assembly1010 in one direction will result in the rotation of theelongated shaft assembly2008 andsurgical end effector2012 about the longitudinal tool axis LT-LT in a first direction and an application of the rotary output motion in an opposite direction will result in the rotation of theelongated shaft assembly2008 andsurgical end effector2012 in a second direction that is opposite to the first direction.
In at least one embodiment, the closure of theanvil2024 relative to thestaple cartridge2034 is accomplished by axially moving theclosure tube assembly2009 in the distal direction “DD” on the spine assembly2049. As indicated above, in various embodiments, theproximal end2060 of theproximal closure tube2040 is supported by theclosure sled2100 which comprises a portion of a closure transmission, generally depicted as2099. In at least one form, theclosure sled2100 is configured to support theclosure tube2009 on the tool mounting plate1320 such that theproximal closure tube2040 can rotate relative to theclosure sled2100, yet travel axially with theclosure sled2100. In particular, as can be seen inFIG. 41, theclosure sled2100 has anupstanding tab2101 that extends into aradial groove2063 in the proximal end portion of theproximal closure tube2040. In addition, as can be seen inFIGS. 39 and 42, theclosure sled2100 has atab portion2102 that extends through aslot1305 in thetool mounting plate1302. Thetab portion2102 is configured to retain theclosure sled2100 in sliding engagement with thetool mounting plate1302. In various embodiments, theclosure sled2100 has anupstanding portion2104 that has aclosure rack gear2106 formed thereon. Theclosure rack gear2106 is configured for driving engagement with aclosure gear assembly2110. SeeFIG. 39.
In various forms, theclosure gear assembly2110 includes aclosure spur gear2112 that is coupled to a corresponding second one of the driven discs orelements1304 on theadapter side1307 of thetool mounting plate1302. SeeFIG. 34. Thus, application of a second rotary output motion from thetool drive assembly1010 of therobotic system1000 to the corresponding second drivenelement1304 will cause rotation of theclosure spur gear2112 when thetool mounting portion1300 is coupled to thetool drive assembly1010. Theclosure gear assembly2110 further includes a closure reduction gear set2114 that is supported in meshing engagement with theclosure spur gear2112. As can be seen inFIGS. 38 and 39, the closurereduction gear set2114 includes a drivengear2116 that is rotatably supported in meshing engagement with theclosure spur gear2112. The closure reduction gear set2114 further includes a firstclosure drive gear2118 that is in meshing engagement with a secondclosure drive gear2120 that is rotatably supported on thetool mounting plate1302 in meshing engagement with theclosure rack gear2106. Thus, application of a second rotary output motion from thetool drive assembly1010 of therobotic system1000 to the corresponding second drivenelement1304 will cause rotation of theclosure spur gear2112 and theclosure transmission2110 and ultimately drive theclosure sled2100 andclosure tube assembly2009 axially. The axial direction in which theclosure tube assembly2009 moves ultimately depends upon the direction in which the second drivenelement1304 is rotated. For example, in response to one rotary output motion received from thetool drive assembly1010 of therobotic system1000, theclosure sled2100 will be driven in the distal direction “DD” and ultimately drive the closure tube assembly1009 in the distal direction. As thedistal closure tube2042 is driven distally, the end of theclosure tube segment2042 will engage a portion of theanvil2024 and cause theanvil2024 to pivot to a closed position. Upon application of an “opening” out put motion from thetool drive assembly1010 of therobotic system1000, theclosure sled2100 andshaft assembly2008 will be driven in the proximal direction “PD”. As thedistal closure tube2042 is driven in the proximal direction, theopening2045 therein interacts with thetab2027 on theanvil2024 to facilitate the opening thereof. In various embodiments, a spring (not shown) may be employed to bias the anvil to the open position when thedistal closure tube2042 has been moved to its starting position. In various embodiments, the various gears of theclosure gear assembly2110 are sized to generate the necessary closure forces needed to satisfactorily close theanvil2024 onto the tissue to be cut and stapled by thesurgical end effector2012. For example, the gears of theclosure transmission2110 may be sized to generate approximately 70-120 pounds.
In various embodiments, thecutting instrument2032 is driven through thesurgical end effector2012 by aknife bar2200. SeeFIGS. 40 and 42. In at least one form, theknife bar2200 may be fabricated from, for example, stainless steel or other similar material and has a substantially rectangular cross-sectional shape. Such knife bar configuration is sufficiently rigid to push thecutting instrument2032 through tissue clamped in thesurgical end effector2012, while still being flexible enough to enable thesurgical end effector2012 to articulate relative to theproximal closure tube2040 and theproximal spine portion2052 about the articulation axis AA-AA as will be discussed in further detail below. As can be seen inFIGS. 43 and 44, theproximal spine portion2052 has a rectangular-shapedpassage2054 extending therethrough to provide support to theknife bar2200 as it is axially pushed therethrough. Theproximal spine portion2052 has aproximal end2056 that is rotatably mounted to aspine mounting bracket2057 attached to the tool mounting plate1032. SeeFIG. 42. Such arrangement permits theproximal spine portion2052 to rotate, but not move axially, within theproximal closure tube2040.
As shown inFIG. 40, thedistal end2202 of theknife bar2200 is attached to thecutting instrument2032. Theproximal end2204 of theknife bar2200 is rotatably affixed to aknife rack gear2206 such that theknife bar2200 is free to rotate relative to theknife rack gear2206. SeeFIG. 39. As can be seen inFIGS. 36-41, theknife rack gear2206 is slidably supported within arack housing2210 that is attached to thetool mounting plate1302 such that theknife rack gear2206 is retained in meshing engagement with aknife gear assembly2220. More specifically and with reference toFIG. 39, in at least one embodiment, theknife gear assembly2220 includes aknife spur gear2222 that is coupled to a corresponding third one of the driven discs orelements1304 on theadapter side1307 of thetool mounting plate1302. SeeFIG. 34. Thus, application of another rotary output motion from therobotic system1000 through thetool drive assembly1010 to the corresponding third drivenelement1304 will cause rotation of theknife spur gear2222. Theknife gear assembly2220 further includes a knife gear reduction set2224 that includes a first knife drivengear2226 and a secondknife drive gear2228. The knife gear reduction set2224 is rotatably mounted to thetool mounting plate1302 such that the firs knife drivengear2226 is in meshing engagement with theknife spur gear2222. Likewise, the secondknife drive gear2228 is in meshing engagement with a thirdknife drive gear2230 that is rotatably supported on thetool mounting plate1302 in meshing engagement with theknife rack gear2206. In various embodiments, the gears of theknife gear assembly2220 are sized to generate the forces needed to drive the cuttingelement2032 through the tissue clamped in thesurgical end effector2012 and actuate the staples therein. For example, the gears of theknife drive assembly2230 may be sized to generate approximately 40 to 100 pounds. It will be appreciated that the application of a rotary output motion from thetool drive assembly1010 in one direction will result in the axial movement of thecutting instrument2032 in a distal direction and application of the rotary output motion in an opposite direction will result in the axial travel of thecutting instrument2032 in a proximal direction.
In various embodiments, thesurgical tool1200 employs and articulation system2007 that includes an articulation joint2011 that enables thesurgical end effector2012 to be articulated about an articulation axis AA-AA that is substantially transverse to the longitudinal tool axis LT-LT. In at least one embodiment, thesurgical tool1200 includes first and second articulation bars2250a,2250bthat are slidably supported withincorresponding passages2053 provided through theproximal spine portion2052. SeeFIGS. 42 and 44. In at least one form, the first and second articulation bars2250a,2250bare actuated by an articulation transmission generally designated as2249 that is operably supported on the tool mounting plate1032. Each of the articulation bars2250a,2250bhas aproximal end2252 that has a guide rod protruding therefrom which extend laterally through a corresponding slot in the proximal end portion of theproximal spine portion2052 and into a corresponding arcuate slot in anarticulation nut2260 which comprises a portion of the articulation transmission.FIG. 43 illustratesarticulation bar2250a. It will be understood thatarticulation bar2250bis similarly constructed. As can be seen inFIG. 40, for example, thearticulation bar2250ahas aguide rod2254 which extends laterally through acorresponding slot2058 in theproximal end portion2056 of thedistal spine portion2050 and into a correspondingarcuate slot2262 in thearticulation nut2260. In addition, thearticulation bar2250ahas adistal end2251athat is pivotally coupled to thedistal spine portion2050 by, for example, apin2253aandarticulation bar2250bhas adistal end2251bthat is pivotally coupled to thedistal spine portion2050 by, for example, apin2253b. In particular, thearticulation bar2250ais laterally offset in a first lateral direction from the longitudinal tool axis LT-LT and thearticulation bar2250bis laterally offset in a second lateral direction from the longitudinal tool axis LT-LT. Thus, axial movement of the articulation bars2250aand2250bin opposing directions will result in the articulation of thedistal spine portion2050 as well as thesurgical end effector2012 attached thereto about the articulation axis AA-AA as will be discussed in further detail below.
Articulation of thesurgical end effector2012 is controlled by rotating thearticulation nut2260 about the longitudinal tool axis LT-LT. Thearticulation nut2260 is rotatably journaled on theproximal end portion2056 of thedistal spine portion2050 and is rotatably driven thereon by anarticulation gear assembly2270. More specifically and with reference toFIG. 37, in at least one embodiment, thearticulation gear assembly2270 includes anarticulation spur gear2272 that is coupled to a corresponding fourth one of the driven discs orelements1304 on theadapter side1307 of thetool mounting plate1302. SeeFIG. 34. Thus, application of another rotary input motion from therobotic system1000 through thetool drive assembly1010 to the corresponding fourth drivenelement1304 will cause rotation of thearticulation spur gear2272 when theinterface1230 is coupled to thetool holder1270. Anarticulation drive gear2274 is rotatably supported on thetool mounting plate1302 in meshing engagement with thearticulation spur gear2272 and agear portion2264 of thearticulation nut2260 as shown. As can be seen inFIGS. 42 and 43, thearticulation nut2260 has ashoulder2266 formed thereon that defines anannular groove2267 for receiving retainingposts2268 therein. Retainingposts2268 are attached to thetool mounting plate1302 and serve to prevent thearticulation nut2260 from moving axially on theproximal spine portion2052 while maintaining the ability to be rotated relative thereto. Thus, rotation of thearticulation nut2260 in a first direction, will result in the axial movement of thearticulation bar2250ain a distal direction “DD” and the axial movement of thearticulation bar2250bin a proximal direction “PD” because of the interaction of theguide rods2254 with thespiral slots2262 in thearticulation gear2260. Similarly, rotation of thearticulation nut2260 in a second direction that is opposite to the first direction will result in the axial movement of thearticulation bar2250ain the proximal direction “PD” as well ascause articulation bar2250bto axially move in the distal direction “DD”. Thus, thesurgical end effector2012 may be selectively articulated about articulation axis “AA-AA” in a first direction “FD” by simultaneously moving thearticulation bar2250ain the distal direction “DD” and thearticulation bar2250bin the proximal direction “PD”. Likewise, thesurgical end effector2012 may be selectively articulated about the articulation axis “AA-AA” in a second direction “SD” by simultaneously moving thearticulation bar2250ain the proximal direction “PD” and thearticulation bar2250bin the distal direction “DD.” SeeFIG. 35.
The tool embodiment described above employs an interface arrangement that is particularly well-suited for mounting the robotically controllable medical tool onto at least one form of robotic arm arrangement that generates at least four different rotary control motions. Those of ordinary skill in the art will appreciate that such rotary output motions may be selectively controlled through the programmable control systems employed by the robotic system/controller. For example, the tool arrangement described above may be well-suited for use with those robotic systems manufactured by Intuitive Surgical, Inc. of Sunnyvale, Calif., U.S.A., many of which may be described in detail in various patents incorporated herein by reference. The unique and novel aspects of various embodiments of the present invention serve to utilize the rotary output motions supplied by the robotic system to generate specific control motions having sufficient magnitudes that enable end effectors to cut and staple tissue. Thus, the unique arrangements and principles of various embodiments of the present invention may enable a variety of different forms of the tool systems disclosed and claimed herein to be effectively employed in connection with other types and forms of robotic systems that supply programmed rotary or other output motions. In addition, as will become further apparent as the present Detailed Description proceeds, various end effector embodiments of the present invention that require other forms of actuation motions may also be effectively actuated utilizing one or more of the control motions generated by the robotic system.
FIGS. 46-50 illustrate yet anothersurgical tool2300 that may be effectively employed in connection with therobotic system1000 that has a tool drive assembly that is operably coupled to a controller of the robotic system that is operable by inputs from an operator and which is configured to provide at least one rotary output motion to at least one rotatable body portion supported on the tool drive assembly. In various forms, thesurgical tool2300 includes asurgical end effector2312 that includes anelongated channel2322 and a pivotally translatable clamping member, such as ananvil2324, which are maintained at a spacing that assures effective stapling and severing of tissue clamped in thesurgical end effector2312. As shown in the illustrated embodiment, thesurgical end effector2312 may include, in addition to the previously-mentionedelongated channel2322 andanvil2324, acutting instrument2332 that has asled portion2333 formed thereon, asurgical staple cartridge2334 that is seated in theelongated channel2322, and a rotary endeffector drive shaft2336 that has a helical screw thread formed thereon. Thecutting instrument2332 may be, for example, a knife. As will be discussed in further detail below, rotation of the endeffector drive shaft2336 will cause thecutting instrument2332 andsled portion2333 to axially travel through thesurgical staple cartridge2334 to move between a starting position and an ending position. The direction of axial travel of thecutting instrument2332 depends upon the direction in which the endeffector drive shaft2336 is rotated. Theanvil2324 may be pivotably opened and closed at apivot point2325 connected to the proximate end of theelongated channel2322. Theanvil2324 may also include atab2327 at its proximate end that operably interfaces with a component of the mechanical closure system (described further below) to open and close theanvil2324. When the endeffector drive shaft2336 is rotated, thecutting instrument2332 andsled2333 will travel longitudinally through thesurgical staple cartridge2334 from the starting position to the ending position, thereby cutting tissue clamped within thesurgical end effector2312. The movement of thesled2333 through thesurgical staple cartridge2334 causes the staples therein to be driven through the severed tissue and against theclosed anvil2324, which turns the staples to fasten the severed tissue. In one form, theelongated channel2322 and theanvil2324 may be made of an electrically conductive material (such as metal) so that they may serve as part of the antenna that communicates with sensor(s) in the end effector, as described above. Thesurgical staple cartridge2334 could be made of a nonconductive material (such as plastic) and the sensor may be connected to or disposed in thesurgical staple cartridge2334, as described above.
It should be noted that although the embodiments of thesurgical tool2300 described herein employ asurgical end effector2312 that staples the severed tissue, in other embodiments different techniques for fastening or sealing the severed tissue may be used. For example, end effectors that use RF energy or adhesives to fasten the severed tissue may also be used. U.S. Pat. No. 5,709,680, entitled “Electrosurgical Hemostatic Device” to Yates et al., and U.S. Pat. No. 5,688,270, entitled “Electrosurgical Hemostatic Device With Recessed And/Or Offset Electrodes” to Yates et al., which are incorporated herein by reference, discloses cutting instruments that use RF energy to fasten the severed tissue. U.S. patent application Ser. No. 11/267,811 to Morgan et al., now U.S. Pat. No. 7,673,783, and U.S. patent application Ser. No. 11/267,383 to Shelton et al., now U.S. Pat. No. 7,607,557, which are also incorporated herein by reference, disclose cutting instruments that use adhesives to fasten the severed tissue. Accordingly, although the description herein refers to cutting/stapling operations and the like, it should be recognized that this is an exemplary embodiment and is not meant to be limiting. Other tissue-fastening techniques may also be used.
In the illustrated embodiment, thesurgical end effector2312 is coupled to anelongated shaft assembly2308 that is coupled to atool mounting portion2460 and defines a longitudinal tool axis LT-LT. In this embodiment, theelongated shaft assembly2308 does not include an articulation joint. Those of ordinary skill in the art will understand that other embodiments may have an articulation joint therein. In at least one embodiment, theelongated shaft assembly2308 comprises a hollowouter tube2340 that is rotatably supported on atool mounting plate2462 of atool mounting portion2460 as will be discussed in further detail below. In various embodiments, theelongated shaft assembly2308 further includes adistal spine shaft2350.Distal spine shaft2350 has adistal end portion2354 that is coupled to, or otherwise integrally formed with, a distalstationary base portion2360 that is non-movably coupled to thechannel2322. SeeFIGS. 47-49.
As shown inFIG. 47, thedistal spine shaft2350 has aproximal end portion2351 that is slidably received within aslot2355 in aproximal spine shaft2353 that is non-movably supported within the hollowouter tube2340 by at least onesupport collar2357. As can be further seen inFIGS. 47 and 48, thesurgical tool2300 includes aclosure tube2370 that is constrained to only move axially relative to the distalstationary base portion2360. Theclosure tube2370 has aproximal end2372 that has aninternal thread2374 formed therein that is in threaded engagement with a transmission arrangement, generally depicted as2375 that is operably supported on thetool mounting plate2462. In various forms, thetransmission arrangement2375 includes a rotary drive shaft assembly, generally designated as2381. When rotated, the rotary drive shaft assembly2381 will cause theclosure tube2370 to move axially as will be describe in further detail below. In at least one form, the rotary drive shaft assembly2381 includes aclosure drive nut2382 of a closure clutch assembly generally designated as2380. More specifically, theclosure drive nut2382 has aproximal end portion2384 that is rotatably supported relative to theouter tube2340 and is in threaded engagement with theclosure tube2370. For assembly purposes, theproximal end portion2384 may be threadably attached to aretention ring2386.Retention ring2386, in cooperation with anend2387 of theclosure drive nut2382, defines anannular slot2388 into which ashoulder2392 of alocking collar2390 extends. Thelocking collar2390 is non-movably attached (e.g., welded, glued, etc.) to the end of theouter tube2340. Such arrangement serves to affix theclosure drive nut2382 to theouter tube2340 while enabling theclosure drive nut2382 to rotate relative to theouter tube2340. Theclosure drive nut2382 further has adistal end2383 that has a threadedportion2385 that threadably engages theinternal thread2374 of theclosure tube2370. Thus, rotation of theclosure drive nut2382 will cause theclosure tube2370 to move axially as represented by arrow “D” inFIG. 48.
Closure of theanvil2324 and actuation of thecutting instrument2332 are accomplished by control motions that are transmitted by ahollow drive sleeve2400. As can be seen inFIGS. 47 and 48, thehollow drive sleeve2400 is rotatably and slidably received on thedistal spine shaft2350. Thedrive sleeve2400 has aproximal end portion2401 that is rotatably mounted to theproximal spine shaft2353 that protrudes from thetool mounting portion2460 such that thedrive sleeve2400 may rotate relative thereto. SeeFIG. 47. As can also be seen inFIGS. 47-49, thedrive sleeve2400 is rotated about the longitudinal tool axis “LT-LT” by adrive shaft2440. Thedrive shaft2440 has adrive gear2444 that is attached to itsdistal end2442 and is in meshing engagement with a drivengear2450 that is attached to thedrive sleeve2400.
Thedrive sleeve2400 further has adistal end portion2402 that is coupled to a closure clutch2410 portion of the closureclutch assembly2380 that has aproximal face2412 and adistal face2414. Theproximal face2412 has a series ofproximal teeth2416 formed thereon that are adapted for selective engagement with correspondingproximal teeth cavities2418 formed in theproximal end portion2384 of theclosure drive nut2382. Thus, when theproximal teeth2416 are in meshing engagement with theproximal teeth cavities2418 in theclosure drive nut2382, rotation of thedrive sleeve2400 will result in rotation of theclosure drive nut2382 and ultimately cause theclosure tube2370 to move axially as will be discussed in further detail below.
As can be most particularly seen inFIGS. 47 and 48, thedistal face2414 of the driveclutch portion2410 has a series ofdistal teeth2415 formed thereon that are adapted for selective engagement with correspondingdistal teeth cavities2426 formed in aface plate portion2424 of a knifedrive shaft assembly2420. In various embodiments, the knifedrive shaft assembly2420 comprises a hollowknife shaft segment2430 that is rotatably received on a corresponding portion of thedistal spine shaft2350 that is attached to or protrudes from thestationary base2360. When thedistal teeth2415 of the closureclutch portion2410 are in meshing engagement with thedistal teeth cavities2426 in theface plate portion2424, rotation of thedrive sleeve2400 will result in rotation of thedrive shaft segment2430 about thestationary shaft2350. As can be seen inFIGS. 47-49, aknife drive gear2432 is attached to thedrive shaft segment2430 and is meshing engagement with adrive knife gear2434 that is attached to the endeffector drive shaft2336. Thus, rotation of thedrive shaft segment2430 will result in the rotation of the endeffector drive shaft2336 to drive the cuttinginstrument2332 andsled2333 distally through thesurgical staple cartridge2334 to cut and staple tissue clamped within thesurgical end effector2312. Thesled2333 may be made of, for example, plastic, and may have a sloped distal surface. As thesled2333 traverses theelongated channel2322, the sloped forward surface of thesled2333 pushes up or “drive” the staples in thesurgical staple cartridge2334 through the clamped tissue and against theanvil2324. Theanvil2324 turns or “forms” the staples, thereby stapling the severed tissue. As used herein, the term “fire” refers to the initiation of actions required to drive the cutting instrument and sled portion in a distal direction through the surgical staple cartridge to cut the tissue clamped in the surgical end effector and drive the staples through the severed tissue.
In use, it may be desirable to rotate thesurgical end effector2312 about the longitudinal tool axis LT-LT. In at least one embodiment, thetransmission arrangement2375 includes arotational transmission assembly2465 that is configured to receive a corresponding rotary output motion from thetool drive assembly1010 of therobotic system1000 and convert that rotary output motion to a rotary control motion for rotating the elongated shaft assembly2308 (and surgical end effector2312) about the longitudinal tool axis LT-LT. As can be seen inFIG. 50, aproximal end2341 of theouter tube2340 is rotatably supported within acradle arrangement2343 attached to thetool mounting plate2462 of thetool mounting portion2460. Arotation gear2345 is formed on or attached to theproximal end2341 of theouter tube2340 of theelongated shaft assembly2308 for meshing engagement with arotation gear assembly2470 operably supported on thetool mounting plate2462. In at least one embodiment, arotation drive gear2472 is coupled to a corresponding first one of the driven discs orelements1304 on the adapter side of thetool mounting plate2462 when thetool mounting portion2460 is coupled to thetool drive assembly1010. SeeFIGS. 34 and 50. Therotation drive assembly2470 further comprises a rotary drivengear2474 that is rotatably supported on thetool mounting plate2462 in meshing engagement with therotation gear2345 and therotation drive gear2472. Application of a first rotary output motion from therobotic system1000 through thetool drive assembly1010 to the corresponding drivenelement1304 will thereby cause rotation of therotation drive gear2472 by virtue of being operably coupled thereto. Rotation of therotation drive gear2472 ultimately results in the rotation of the elongated shaft assembly2308 (and the end effector2312) about the longitudinal tool axis LT-LT (primary rotary motion).
Closure of theanvil2324 relative to thestaple cartridge2034 is accomplished by axially moving theclosure tube2370 in the distal direction “DD”. Axial movement of theclosure tube2370 in the distal direction “DD” is accomplished by applying a rotary control motion to theclosure drive nut2382. To apply the rotary control motion to theclosure drive nut2382, the closure clutch2410 must first be brought into meshing engagement with theproximal end portion2384 of theclosure drive nut2382. In various embodiments, thetransmission arrangement2375 further includes ashifter drive assembly2480 that is operably supported on thetool mounting plate2462. More specifically and with reference toFIG. 50, it can be seen that aproximal end portion2359 of theproximal spine portion2353 extends through therotation gear2345 and is rotatably coupled to ashifter gear rack2481 that is slidably affixed to thetool mounting plate2462 throughslots2482. Theshifter drive assembly2480 further comprises a shifter drive gear2483 that is coupled to a corresponding second one of the driven discs orelements1304 on the adapter side of thetool mounting plate2462 when thetool mounting portion2460 is coupled to thetool holder1270. SeeFIGS. 34 and 50. Theshifter drive assembly2480 further comprises a shifter driven gear2478 that is rotatably supported on thetool mounting plate2462 in meshing engagement with the shifter drive gear2483 and theshifter rack gear2482. Application of a second rotary output motion from therobotic system1000 through thetool drive assembly1010 to the corresponding drivenelement1304 will thereby cause rotation of the shifter drive gear2483 by virtue of being operably coupled thereto. Rotation of the shifter drive gear2483 ultimately results in the axial movement of theshifter gear rack2482 and theproximal spine portion2353 as well as thedrive sleeve2400 and the closure clutch2410 attached thereto. The direction of axial travel of the closure clutch2410 depends upon the direction in which the shifter drive gear2483 is rotated by therobotic system1000. Thus, rotation of the shifter drive gear2483 in a first rotary direction will result in the axial movement of the closure clutch2410 in the proximal direction “PD” to bring theproximal teeth2416 into meshing engagement with theproximal teeth cavities2418 in theclosure drive nut2382. Conversely, rotation of the shifter drive gear2483 in a second rotary direction (opposite to the first rotary direction) will result in the axial movement of the closure clutch2410 in the distal direction “DD” to bring thedistal teeth2415 into meshing engagement with correspondingdistal teeth cavities2426 formed in theface plate portion2424 of the knifedrive shaft assembly2420.
Once the closure clutch2410 has been brought into meshing engagement with theclosure drive nut2382, theclosure drive nut2382 is rotated by rotating theclosure clutch2410. Rotation of the closure clutch2410 is controlled by applying rotary output motions to a rotarydrive transmission portion2490 oftransmission arrangement2375 that is operably supported on thetool mounting plate2462 as shown inFIG. 50. In at least one embodiment, therotary drive transmission2490 includes arotary drive assembly2490′ that includes agear2491 that is coupled to a corresponding third one of the driven discs orelements1304 on the adapter side of thetool mounting plate2462 when thetool mounting portion2460 is coupled to thetool holder1270. SeeFIGS. 34 and 50. Therotary drive transmission2490 further comprises a first rotary drivengear2492 that is rotatably supported on thetool mounting plate2462 in meshing engagement with a second rotary drivengear2493 and therotary drive gear2491. The second rotary drivengear2493 is coupled to aproximal end portion2443 of thedrive shaft2440.
Rotation of therotary drive gear2491 in a first rotary direction will result in the rotation of thedrive shaft2440 in a first direction. Conversely, rotation of therotary drive gear2491 in a second rotary direction (opposite to the first rotary direction) will cause thedrive shaft2440 to rotate in a second direction. As indicated above, thedrive shaft2440 has adrive gear2444 that is attached to itsdistal end2442 and is in meshing engagement with a drivengear2450 that is attached to thedrive sleeve2400. Thus, rotation of thedrive shaft2440 results in rotation of thedrive sleeve2400.
A method of operating thesurgical tool2300 will now be described. Once thetool mounting portion2462 has been operably coupled to thetool holder1270 of therobotic system1000 and oriented into position adjacent the target tissue to be cut and stapled, if theanvil2334 is not already in the open position (FIG. 47), therobotic system1000 may apply the first rotary output motion to the shifter drive gear2483 which results in the axial movement of the closure clutch2410 into meshing engagement with the closure drive nut2382 (if it is not already in meshing engagement therewith). SeeFIG. 48. Once thecontroller1001 of therobotic system1000 has confirmed that the closure clutch2410 is meshing engagement with the closure drive nut2382 (e.g., by means of sensor(s)) in thesurgical end effector2312 that are in communication with the robotic control system), therobotic controller1001 may then apply a second rotary output motion to therotary drive gear2492 which, as was described above, ultimately results in the rotation of therotary drive nut2382 in the first direction which results in the axial travel of theclosure tube2370 in the distal direction “DD”. As theclosure tube2370 moved in the distal direction, it contacts a portion of the anvil2323 and causes theanvil2324 to pivot to the closed position to clamp the target tissue between theanvil2324 and thesurgical staple cartridge2334. Once therobotic controller1001 determines that theanvil2334 has been pivoted to the closed position by corresponding sensor(s) in thesurgical end effector2312 in communication therewith, therobotic system1000 discontinues the application of the second rotary output motion to therotary drive gear2491. Therobotic controller1001 may also provide the surgeon with an indication that theanvil2334 has been fully closed. The surgeon may then initiate the firing procedure. In alternative embodiments, the firing procedure may be automatically initiated by therobotic controller1001. Therobotic controller1001 then applies the primary rotary control motion2483 to the shifter drive gear2483 which results in the axial movement of the closure clutch2410 into meshing engagement with theface plate portion2424 of the knifedrive shaft assembly2420. SeeFIG. 49. Once thecontroller1001 of therobotic system1000 has confirmed that the closure clutch2410 is meshing engagement with the face plate portion2424 (by means of sensor(s)) in theend effector2312 that are in communication with the robotic controller1001), therobotic controller1001 may then apply the second rotary output motion to therotary drive gear2492 which, as was described above, ultimately results in the axial movement of thecutting instrument2332 andsled portion2333 in the distal direction “DD” through thesurgical staple cartridge2334. As thecutting instrument2332 moves distally through thesurgical staple cartridge2334, the tissue clamped therein is severed. As thesled portion2333 is driven distally, it causes the staples within the surgical staple cartridge to be driven through the severed tissue into forming contact with theanvil2324. Once therobotic controller1001 has determined that thecutting instrument2324 has reached the end position within the surgical staple cartridge2334 (by means of sensor(s)) in theend effector2312 that are in communication with the robotic controller1001), therobotic controller1001 discontinues the application of the second rotary output motion to therotary drive gear2491. Thereafter, therobotic controller1001 applies the secondary rotary output motion to therotary drive gear2491 which ultimately results in the axial travel of thecutting instrument2332 andsled portion2333 in the proximal direction “PD” to the starting position. Once therobotic controller1001 has determined that thecutting instrument2324 has reached the staring position by means of sensor(s) in thesurgical end effector2312 that are in communication with therobotic controller1001, therobotic controller1001 discontinues the application of the secondary rotary output motion to therotary drive gear2491. Thereafter, therobotic controller1001 applies the primary rotary output motion to the shifter drive gear2483 to cause the closure clutch2410 to move into engagement with therotary drive nut2382. Once the closure clutch2410 has been moved into meshing engagement with therotary drive nut2382, therobotic controller1001 then applies the secondary output motion to therotary drive gear2491 which ultimately results in the rotation of therotary drive nut2382 in the second direction to cause theclosure tube2370 to move in the proximal direction “PD”. As can be seen inFIGS. 47-49, theclosure tube2370 has anopening2345 therein that engages thetab2327 on theanvil2324 to cause theanvil2324 to pivot to the open position. In alternative embodiments, a spring may also be employed to pivot theanvil2324 to the open position when theclosure tube2370 has been returned to the starting position (FIG. 47).
FIGS. 51-55 illustrate yet anothersurgical tool2500 that may be effectively employed in connection with therobotic system1000. In various forms, thesurgical tool2500 includes asurgical end effector2512 that includes a “first portion” in the form of anelongated channel2522 and a “second movable portion” in the form of a pivotally translatable clamping member, such as ananvil2524, which are maintained at a spacing that assures effective stapling and severing of tissue clamped in thesurgical end effector2512. As shown in the illustrated embodiment, thesurgical end effector2512 may include, in addition to the previously-mentionedelongated channel2522 andanvil2524, a “third movable portion” in the form of acutting instrument2532, a sled (not shown), and asurgical staple cartridge2534 that is removably seated in theelongated channel2522. Thecutting instrument2532 may be, for example, a knife. Theanvil2524 may be pivotably opened and closed at apivot point2525 connected to the proximate end of theelongated channel2522. Theanvil2524 may also include atab2527 at its proximate end that is configured to operably interface with a component of the mechanical closure system (described further below) to open and close theanvil2524. When actuated, theknife2532 and sled travel longitudinally along theelongated channel2522, thereby cutting tissue clamped within thesurgical end effector2512. The movement of the sled along theelongated channel2522 causes the staples of thesurgical staple cartridge2534 to be driven through the severed tissue and against theclosed anvil2524, which turns the staples to fasten the severed tissue. In one form, theelongated channel2522 and theanvil2524 may be made of an electrically conductive material (such as metal) so that they may serve as part of the antenna that communicates with sensor(s) in the surgical end effector, as described above. Thesurgical staple cartridge2534 could be made of a nonconductive material (such as plastic) and the sensor may be connected to or disposed in thesurgical staple cartridge2534, as described above.
It should be noted that although the embodiments of thesurgical tool2500 described herein employ asurgical end effector2512 that staples the severed tissue, in other embodiments different techniques for fastening or sealing the severed tissue may be used. For example, end effectors that use RF energy or adhesives to fasten the severed tissue may also be used. U.S. Pat. No. 5,709,680, entitled “Electrosurgical Hemostatic Device” to Yates et al., and U.S. Pat. No. 5,688,270, entitled “Electrosurgical Hemostatic Device With Recessed And/Or Offset Electrodes” to Yates et al., which are incorporated herein by reference, discloses cutting instruments that use RF energy to fasten the severed tissue. U.S. patent application Ser. No. 11/267,811 to Morgan et al., now U.S. Pat. No. 7,673,783, and U.S. patent application Ser. No. 11/267,383 to Shelton et al., now U.S. Pat. No. 7,607,557, which are also incorporated herein by reference, disclose cutting instruments that use adhesives to fasten the severed tissue. Accordingly, although the description herein refers to cutting/stapling operations and the like, it should be recognized that this is an exemplary embodiment and is not meant to be limiting. Other tissue-fastening techniques may also be used.
In the illustrated embodiment, theelongated channel2522 of thesurgical end effector2512 is coupled to anelongated shaft assembly2508 that is coupled to atool mounting portion2600. In at least one embodiment, theelongated shaft assembly2508 comprises ahollow spine tube2540 that is non-movably coupled to atool mounting plate2602 of thetool mounting portion2600. As can be seen inFIGS. 52 and 53, theproximal end2523 of theelongated channel2522 comprises a hollow tubular structure configured to be attached to thedistal end2541 of thespine tube2540. In one embodiment, for example, theproximal end2523 of theelongated channel2522 is welded or glued to the distal end of thespine tube2540.
As can be further seen inFIGS. 52 and 53, in at least one non-limiting embodiment, thesurgical tool2500 further includes an axially movable actuation member in the form of aclosure tube2550 that is constrained to move axially relative to theelongated channel2522 and the spine tube1540. Theclosure tube2550 has aproximal end2552 that has aninternal thread2554 formed therein that is in threaded engagement with a rotatably movable portion in the form of aclosure drive nut2560. More specifically, theclosure drive nut2560 has aproximal end portion2562 that is rotatably supported relative to theelongated channel2522 and thespine tube2540. For assembly purposes, theproximal end portion2562 is threadably attached to aretention ring2570. Theretention ring2570 is received in agroove2529 formed between ashoulder2527 on theproximal end2523 of theelongated channel2522 and thedistal end2541 of the spine tube1540. Such arrangement serves to rotatably support theclosure drive nut2560 within theelongated channel2522. Rotation of theclosure drive nut2560 will cause theclosure tube2550 to move axially as represented by arrow “D” inFIG. 52.
Extending through thespine tube2540 and theclosure drive nut2560 is a drive member which, in at least one embodiment, comprises aknife bar2580 that has adistal end portion2582 that is rotatably coupled to thecutting instrument2532 such that theknife bar2580 may rotate relative to thecutting instrument2582. As can be seen inFIG. 52-54, theclosure drive nut2560 has aslot2564 therein through which theknife bar2580 can slidably extend. Such arrangement permits theknife bar2580 to move axially relative to theclosure drive nut2560. However, rotation of theknife bar2580 about the longitudinal tool axis LT-LT will also result in the rotation of theclosure drive nut2560. The axial direction in which theclosure tube2550 moves ultimately depends upon the direction in which theknife bar2580 and theclosure drive nut2560 are rotated. As theclosure tube2550 is driven distally, the distal end thereof will contact theanvil2524 and cause theanvil2524 to pivot to a closed position. Upon application of an opening rotary output motion from therobotic system1000, theclosure tube2550 will be driven in the proximal direction “PD” and pivot theanvil2524 to the open position by virtue of the engagement of thetab2527 with theopening2555 in theclosure tube2550.
In use, it may be desirable to rotate thesurgical end effector2512 about the longitudinal tool axis LT-LT. In at least one embodiment, thetool mounting portion2600 is configured to receive a corresponding first rotary output motion from therobotic system1000 and convert that first rotary output motion to a rotary control motion for rotating theelongated shaft assembly2508 about the longitudinal tool axis LT-LT. As can be seen inFIG. 55, aproximal end2542 of thehollow spine tube2540 is rotatably supported within acradle arrangement2603 attached to atool mounting plate2602 of thetool mounting portion2600. Various embodiments of thesurgical tool2500 further include a transmission arrangement, generally depicted as2605, that is operably supported on thetool mounting plate2602. In various forms thetransmission arrangement2605 include arotation gear2544 that is formed on or attached to theproximal end2542 of thespine tube2540 for meshing engagement with arotation drive assembly2610 that is operably supported on thetool mounting plate2602. In at least one embodiment, arotation drive gear2612 is coupled to a corresponding first one of the rotational bodies, driven discs orelements1304 on the adapter side of thetool mounting plate2602 when thetool mounting portion2600 is coupled to thetool holder1270. SeeFIGS. 34 and 55. Therotation drive assembly2610 further comprises a rotary drivengear2614 that is rotatably supported on thetool mounting plate2602 in meshing engagement with therotation gear2544 and therotation drive gear2612. Application of a first rotary output motion from therobotic system1000 through thetool drive assembly1010 to the corresponding drivenrotational body1304 will thereby cause rotation of therotation drive gear2612 by virtue of being operably coupled thereto. Rotation of therotation drive gear2612 ultimately results in the rotation of the elongated shaft assembly2508 (and the end effector2512) about the longitudinal tool axis LT-LT.
Closure of theanvil2524 relative to thesurgical staple cartridge2534 is accomplished by axially moving theclosure tube2550 in the distal direction “DD”. Axial movement of theclosure tube2550 in the distal direction “DD” is accomplished by applying a rotary control motion to theclosure drive nut2382. In various embodiments, theclosure drive nut2560 is rotated by applying a rotary output motion to theknife bar2580. Rotation of theknife bar2580 is controlled by applying rotary output motions to arotary closure system2620 that is operably supported on thetool mounting plate2602 as shown inFIG. 55. In at least one embodiment, therotary closure system2620 includes aclosure drive gear2622 that is coupled to a corresponding second one of the driven rotatable body portions discs orelements1304 on the adapter side of thetool mounting plate2462 when thetool mounting portion2600 is coupled to thetool holder1270. SeeFIGS. 34 and 55. Theclosure drive gear2622, in at least one embodiment, is in meshing driving engagement with a closure gear train, generally depicted as2623. The closuregear drive rain2623 comprises a first drivenclosure gear2624 that is rotatably supported on thetool mounting plate2602. The first closure drivengear2624 is attached to a second closure drivengear2626 by adrive shaft2628. The second closure drivengear2626 is in meshing engagement with a third closure drivengear2630 that is rotatably supported on thetool mounting plate2602. Rotation of theclosure drive gear2622 in a second rotary direction will result in the rotation of the third closure drivengear2630 in a second direction. Conversely, rotation of the closure drive gear2483 in a secondary rotary direction (opposite to the second rotary direction) will cause the third closure drivengear2630 to rotate in a secondary direction.
As can be seen inFIG. 55, adrive shaft assembly2640 is coupled to a proximal end of theknife bar2580. In various embodiments, thedrive shaft assembly2640 includes aproximal portion2642 that has a square cross-sectional shape. Theproximal portion2642 is configured to slideably engage a correspondingly shaped aperture in the third drivengear2630. Such arrangement results in the rotation of the drive shaft assembly2640 (and knife bar2580) when the third drivengear2630 is rotated. Thedrive shaft assembly2640 is axially advanced in the distal and proximal directions by aknife drive assembly2650. One form of theknife drive assembly2650 comprises arotary drive gear2652 that is coupled to a corresponding third one of the driven rotatable body portions, discs orelements1304 on the adapter side of thetool mounting plate2462 when thetool mounting portion2600 is coupled to thetool holder1270. SeeFIGS. 34 and 55. The rotary drivengear2652 is in meshing driving engagement with a gear train, generally depicted as2653. In at least one form, thegear train2653 further comprises a first rotary drivengear assembly2654 that is rotatably supported on thetool mounting plate2602. The first rotary drivengear assembly2654 is in meshing engagement with a third rotary drivengear assembly2656 that is rotatably supported on thetool mounting plate2602 and which is in meshing engagement with a fourth rotary drivengear assembly2658 that is in meshing engagement with a threadedportion2644 of thedrive shaft assembly2640. Rotation of therotary drive gear2652 in a third rotary direction will result in the axial advancement of thedrive shaft assembly2640 andknife bar2580 in the distal direction “DD”. Conversely, rotation of therotary drive gear2652 in a tertiary rotary direction (opposite to the third rotary direction) will cause thedrive shaft assembly2640 and theknife bar2580 to move in the proximal direction.
A method of operating thesurgical tool2500 will now be described. Once thetool mounting portion2600 has been operably coupled to thetool holder1270 of therobotic system1000, therobotic system1000 can orient thesurgical end effector2512 in position adjacent the target tissue to be cut and stapled. If theanvil2524 is not already in the open position (FIG. 52), therobotic system1000 may apply the second rotary output motion to theclosure drive gear2622 which results in the rotation of theknife bar2580 in a second direction. Rotation of theknife bar2580 in the second direction results in the rotation of theclosure drive nut2560 in a second direction. As theclosure drive nut2560 rotates in the second direction, theclosure tube2550 moves in the proximal direction “PD”. As theclosure tube2550 moves in the proximal direction “PD”, thetab2527 on theanvil2524 interfaces with theopening2555 in theclosure tube2550 and causes theanvil2524 to pivot to the open position. In addition or in alternative embodiments, a spring (not shown) may be employed to pivot theanvil2354 to the open position when theclosure tube2550 has been returned to the starting position (FIG. 52). The openedsurgical end effector2512 may then be manipulated by therobotic system1000 to position the target tissue between theopen anvil2524 and thesurgical staple cartridge2534. Thereafter, the surgeon may initiate the closure process by activating therobotic control system1000 to apply the second rotary output motion to theclosure drive gear2622 which, as was described above, ultimately results in the rotation of theclosure drive nut2382 in the second direction which results in the axial travel of the closure tube2250 in the distal direction “DD”. As theclosure tube2550 moves in the distal direction, it contacts a portion of theanvil2524 and causes theanvil2524 to pivot to the closed position to clamp the target tissue between theanvil2524 and thestaple cartridge2534. Once therobotic controller1001 determines that theanvil2524 has been pivoted to the closed position by corresponding sensor(s) in theend effector2512 that are in communication therewith, therobotic controller1001 discontinues the application of the second rotary output motion to theclosure drive gear2622. Therobotic controller1001 may also provide the surgeon with an indication that theanvil2524 has been fully closed. The surgeon may then initiate the firing procedure. In alternative embodiments, the firing procedure may be automatically initiated by therobotic controller1001.
After therobotic controller1001 has determined that theanvil2524 is in the closed position, therobotic controller1001 then applies the third rotary output motion to therotary drive gear2652 which results in the axial movement of thedrive shaft assembly2640 andknife bar2580 in the distal direction “DD”. As thecutting instrument2532 moves distally through thesurgical staple cartridge2534, the tissue clamped therein is severed. As the sled portion (not shown) is driven distally, it causes the staples within thesurgical staple cartridge2534 to be driven through the severed tissue into forming contact with theanvil2524. Once therobotic controller1001 has determined that thecutting instrument2532 has reached the end position within thesurgical staple cartridge2534 by means of sensor(s) in thesurgical end effector2512 that are in communication with therobotic controller1001, therobotic controller1001 discontinues the application of the second rotary output motion to therotary drive gear2652. Thereafter, therobotic controller1001 applies the secondary rotary control motion to therotary drive gear2652 which ultimately results in the axial travel of thecutting instrument2532 and sled portion in the proximal direction “PD” to the starting position. Once therobotic controller1001 has determined that thecutting instrument2524 has reached the staring position by means of sensor(s) in theend effector2512 that are in communication with therobotic controller1001, therobotic controller1001 discontinues the application of the secondary rotary output motion to therotary drive gear2652. Thereafter, therobotic controller1001 may apply the secondary rotary output motion to theclosure drive gear2622 which results in the rotation of theknife bar2580 in a secondary direction. Rotation of theknife bar2580 in the secondary direction results in the rotation of theclosure drive nut2560 in a secondary direction. As theclosure drive nut2560 rotates in the secondary direction, theclosure tube2550 moves in the proximal direction “PD” to the open position.
FIGS. 56-61B illustrate yet anothersurgical tool2700 that may be effectively employed in connection with therobotic system1000. In various forms, thesurgical tool2700 includes asurgical end effector2712 that includes a “first portion” in the form of anelongated channel2722 and a “second movable portion” in on form comprising a pivotally translatable clamping member, such as ananvil2724, which are maintained at a spacing that assures effective stapling and severing of tissue clamped in thesurgical end effector2712. As shown in the illustrated embodiment, thesurgical end effector2712 may include, in addition to the previously-mentionedchannel2722 andanvil2724, a “third movable portion” in the form of acutting instrument2732, a sled (not shown), and asurgical staple cartridge2734 that is removably seated in theelongated channel2722. Thecutting instrument2732 may be, for example, a knife. Theanvil2724 may be pivotably opened and closed at apivot point2725 connected to the proximal end of theelongated channel2722. Theanvil2724 may also include atab2727 at its proximal end that interfaces with a component of the mechanical closure system (described further below) to open and close theanvil2724. When actuated, theknife2732 and sled to travel longitudinally along theelongated channel2722, thereby cutting tissue clamped within thesurgical end effector2712. The movement of the sled along theelongated channel2722 causes the staples of thesurgical staple cartridge2734 to be driven through the severed tissue and against theclosed anvil2724, which turns the staples to fasten the severed tissue. In one form, theelongated channel2722 and theanvil2724 may be made of an electrically conductive material (such as metal) so that they may serve as part of the antenna that communicates with sensor(s) in the surgical end effector, as described above. Thesurgical staple cartridge2734 could be made of a nonconductive material (such as plastic) and the sensor may be connected to or disposed in thesurgical staple cartridge2734, as described above.
It should be noted that although the embodiments of thesurgical tool2500 described herein employ asurgical end effector2712 that staples the severed tissue, in other embodiments different techniques for fastening or sealing the severed tissue may be used. For example, end effectors that use RF energy or adhesives to fasten the severed tissue may also be used. U.S. Pat. No. 5,709,680, entitled “Electrosurgical Hemostatic Device” to Yates et al., and U.S. Pat. No. 5,688,270, entitled “Electrosurgical Hemostatic Device With Recessed And/Or Offset Electrodes” to Yates et al., which are incorporated herein by reference, discloses cutting instruments that use RF energy to fasten the severed tissue. U.S. patent application Ser. No. 11/267,811 to Morgan et al., now U.S, Pat. No. 7,673,783, and U.S. patent application Ser. No. 11/267,383 to Shelton et al., now U.S. Pat. No. 7,607,557, which are also incorporated herein by reference, disclose cutting instruments that use adhesives to fasten the severed tissue. Accordingly, although the description herein refers to cutting/stapling operations and the like, it should be recognized that this is an exemplary embodiment and is not meant to be limiting. Other tissue-fastening techniques may also be used.
In the illustrated embodiment, theelongated channel2722 of thesurgical end effector2712 is coupled to anelongated shaft assembly2708 that is coupled to atool mounting portion2900. Although not shown, theelongated shaft assembly2708 may include an articulation joint to permit thesurgical end effector2712 to be selectively articulated about an axis that is substantially transverse to the tool axis LT-LT. In at least one embodiment, theelongated shaft assembly2708 comprises ahollow spine tube2740 that is non-movably coupled to atool mounting plate2902 of thetool mounting portion2900. As can be seen inFIGS. 57 and 58, theproximal end2723 of theelongated channel2722 comprises a hollow tubular structure that is attached to thespine tube2740 by means of a mountingcollar2790. A cross-sectional view of the mountingcollar2790 is shown inFIG. 59. In various embodiments, the mountingcollar2790 has a proximalflanged end2791 that is configured for attachment to the distal end of thespine tube2740. In at least one embodiment, for example, the proximalflanged end2791 of the mountingcollar2790 is welded or glued to the distal end of thespine tube2740. As can be further seen inFIGS. 57 and 58, the mountingcollar2790 further has a mountinghub portion2792 that is sized to receive theproximal end2723 of theelongated channel2722 thereon. Theproximal end2723 of theelongated channel2722 is non-movably attached to the mountinghub portion2792 by, for example, welding, adhesive, etc.
As can be further seen inFIGS. 57 and 58, thesurgical tool2700 further includes an axially movable actuation member in the form of aclosure tube2750 that is constrained to move axially relative to theelongated channel2722. Theclosure tube2750 has aproximal end2752 that has an internal thread2754 formed therein that is in threaded engagement with a rotatably movable portion in the form of aclosure drive nut2760. More specifically, theclosure drive nut2760 has a proximal end portion2762 that is rotatably supported relative to theelongated channel2722 and thespine tube2740. For assembly purposes, the proximal end portion2762 is threadably attached to aretention ring2770. Theretention ring2770 is received in a groove2729 formed between ashoulder2727 on theproximal end2723 of thechannel2722 and the mounting hub2729 of the mountingcollar2790. Such arrangement serves to rotatably support theclosure drive nut2760 within thechannel2722. Rotation of theclosure drive nut2760 will cause theclosure tube2750 to move axially as represented by arrow “D” inFIG. 57.
Extending through thespine tube2740, the mountingcollar2790, and theclosure drive nut2760 is a drive member, which in at least one embodiment, comprises aknife bar2780 that has adistal end portion2782 that is coupled to thecutting instrument2732. As can be seen inFIGS. 57 and 58, the mountingcollar2790 has apassage2793 therethrough for permitting theknife bar2780 to slidably pass therethrough. Similarly, theclosure drive nut2760 has a slot2764 therein through which theknife bar2780 can slidably extend. Such arrangement permits theknife bar2780 to move axially relative to theclosure drive nut2760.
Actuation of theanvil2724 is controlled by a rotary drivenclosure shaft2800. As can be seen inFIGS. 57 and 58, adistal end portion2802 of theclosure drive shaft2800 extends through apassage2794 in the mountingcollar2790 and aclosure gear2804 is attached thereto. Theclosure gear2804 is configured for driving engagement with theinner surface2761 of theclosure drive nut2760. Thus, rotation of theclosure shaft2800 will also result in the rotation of theclosure drive nut2760. The axial direction in which theclosure tube2750 moves ultimately depends upon the direction in which theclosure shaft2800 and theclosure drive nut2760 are rotated. For example, in response to one rotary closure motion received from therobotic system1000, theclosure tube2750 will be driven in the distal direction “DD”. As theclosure tube2750 is driven distally, the opening2745 will engage thetab2727 on theanvil2724 and cause theanvil2724 to pivot to a closed position. Upon application of an opening rotary motion from therobotic system1000, theclosure tube2750 will be driven in the proximal direction “PD” and pivot theanvil2724 to the open position. In various embodiments, a spring (not shown) may be employed to bias theanvil2724 to the open position (FIG. 57).
In use, it may be desirable to rotate thesurgical end effector2712 about the longitudinal tool axis LT-LT. In at least one embodiment, thetool mounting portion2900 is configured to receive a corresponding first rotary output motion from therobotic system1000 for rotating theelongated shaft assembly2708 about the tool axis LT-LT. As can be seen inFIG. 61, aproximal end2742 of thehollow spine tube2740 is rotatably supported within acradle arrangement2903 and abearing assembly2904 that are attached to atool mounting plate2902 of thetool mounting portion2900. Arotation gear2744 is formed on or attached to theproximal end2742 of thespine tube2740 for meshing engagement with arotation drive assembly2910 that is operably supported on thetool mounting plate2902. In at least one embodiment, a rotation drive gear2912 is coupled to a corresponding first one of the driven discs orelements1304 on the adapter side of thetool mounting plate2602 when thetool mounting portion2600 is coupled to thetool holder1270. SeeFIGS. 34 and 61. Therotation drive assembly2910 further comprises a rotary drivengear2914 that is rotatably supported on thetool mounting plate2902 in meshing engagement with therotation gear2744 and the rotation drive gear2912. Application of a first rotary control motion from therobotic system1000 through thetool holder1270 and theadapter1240 to the corresponding drivenelement1304 will thereby cause rotation of the rotation drive gear2912 by virtue of being operably coupled thereto. Rotation of the rotation drive gear2912 ultimately results in the rotation of the elongated shaft assembly2708 (and the end effector2712) about the longitudinal tool axis LT-LT (primary rotary motion).
Closure of theanvil2724 relative to thestaple cartridge2734 is accomplished by axially moving theclosure tube2750 in the distal direction “DD”. Axial movement of theclosure tube2750 in the distal direction “DD” is accomplished by applying a rotary control motion to theclosure drive nut2760. In various embodiments, theclosure drive nut2760 is rotated by applying a rotary output motion to theclosure drive shaft2800. As can be seen inFIG. 61, aproximal end portion2806 of theclosure drive shaft2800 has a drivengear2808 thereon that is in meshing engagement with aclosure drive assembly2920. In various embodiments, theclosure drive system2920 includes aclosure drive gear2922 that is coupled to a corresponding second one of the driven rotational bodies orelements1304 on the adapter side of thetool mounting plate2462 when thetool mounting portion2900 is coupled to thetool holder1270. SeeFIGS. 34 and 61. Theclosure drive gear2922 is supported in meshing engagement with a closure gear train, generally depicted as2923. In at least one form, the closure gear rain2923 comprises a first drivenclosure gear2924 that is rotatably supported on thetool mounting plate2902. The first closure drivengear2924 is attached to a second closure drivengear2926 by adrive shaft2928. The second closure drivengear2926 is in meshing engagement with aplanetary gear assembly2930. In various embodiments, theplanetary gear assembly2930 includes a drivenplanetary closure gear2932 that is rotatably supported within thebearing assembly2904 that is mounted ontool mounting plate2902. As can be seen inFIGS. 61 and 61B, theproximal end portion2806 of theclosure drive shaft2800 is rotatably supported within theproximal end portion2742 of thespine tube2740 such that the drivengear2808 is in meshing engagement withcentral gear teeth2934 formed on theplanetary gear2932. As can also be seen inFIG. 61A, two additional support gears2936 are attached to or rotatably supported relative to theproximal end portion2742 of thespine tube2740 to provide bearing support thereto. Such arrangement with theplanetary gear assembly2930 serves to accommodate rotation of thespine shaft2740 by therotation drive assembly2910 while permitting the closure drivengear2808 to remain in meshing engagement with theclosure drive system2920. In addition, rotation of theclosure drive gear2922 in a first direction will ultimately result in the rotation of theclosure drive shaft2800 andclosure drive nut2760 which will ultimately result in the closure of theanvil2724 as described above. Conversely, rotation of theclosure drive gear2922 in a second opposite direction will ultimately result in the rotation of theclosure drive nut2760 in an opposite direction which results in the opening of theanvil2724.
As can be seen inFIG. 61, theproximal end2784 of theknife bar2780 has a threadedshaft portion2786 attached thereto which is in driving engagement with aknife drive assembly2940. In various embodiments, the threadedshaft portion2786 is rotatably supported by abearing2906 attached to thetool mounting plate2902. Such arrangement permits the threadedshaft portion2786 to rotate and move axially relative to thetool mounting plate2902. Theknife bar2780 is axially advanced in the distal and proximal directions by theknife drive assembly2940. One form of theknife drive assembly2940 comprises arotary drive gear2942 that is coupled to a corresponding third one of the rotatable bodies, driven discs orelements1304 on the adapter side of thetool mounting plate2902 when thetool mounting portion2900 is coupled to thetool holder1270. SeeFIGS. 34 and 61. Therotary drive gear2942 is in meshing engagement with a knife gear train, generally depicted as2943. In various embodiments, theknife gear train2943 comprises a first rotary drivengear assembly2944 that is rotatably supported on thetool mounting plate2902. The first rotary drivengear assembly2944 is in meshing engagement with a third rotary drivengear assembly2946 that is rotatably supported on thetool mounting plate2902 and which is in meshing engagement with a fourth rotary drivengear assembly2948 that is in meshing engagement with the threadedportion2786 of theknife bar2780. Rotation of therotary drive gear2942 in one direction will result in the axial advancement of theknife bar2780 in the distal direction “DD”. Conversely, rotation of therotary drive gear2942 in an opposite direction will cause theknife bar2780 to move in the proximal direction.Tool2700 may otherwise be used as described above.
FIGS. 62 and 63 illustrate asurgical tool embodiment2700 that is substantially identical totool2700 that was described in detail above. Howevertool2700′ includes a pressure sensor2950 that is configured to provide feedback to therobotic controller1001 concerning the amount of clamping pressure experienced by theanvil2724. In various embodiments, for example, the pressure sensor may comprise a spring biased contact switch. For a continuous signal, it would use either a cantilever beam with a strain gage on it or a dome button top with a strain gage on the inside. Another version may comprise an off switch that contacts only at a known desired load. Such arrangement would include a dome on the based wherein the dome is one electrical pole and the base is the other electrical pole. Such arrangement permits therobotic controller1001 to adjust the amount of clamping pressure being applied to the tissue within thesurgical end effector2712 by adjusting the amount of closing pressure applied to theanvil2724. Those of ordinary skill in the art will understand that such pressure sensor arrangement may be effectively employed with several of the surgical tool embodiments described herein as well as their equivalent structures.
FIG. 64 illustrates a portion of anothersurgical tool3000 that may be effectively used in connection with arobotic system1000. Thesurgical tool3003 employs on-board motor(s) for powering various components of a surgical end effector cutting instrument. In at least one non-limiting embodiment for example, thesurgical tool3000 includes a surgical end effector in the form of an endocutter (not shown) that has an anvil (not shown) and surgical staple cartridge arrangement (not shown) of the types and constructions described above. Thesurgical tool3000 also includes an elongated shaft (not shown) and anvil closure arrangement (not shown) of the types described above. Thus, this portion of the Detailed Description will not repeat the description of those components beyond that which is necessary to appreciate the unique and novel attributes of the various embodiments ofsurgical tool3000.
In the depicted embodiment, the end effector includes acutting instrument3002 that is coupled to aknife bar3003. As can be seen inFIG. 64, thesurgical tool3000 includes atool mounting portion3010 that includes atool mounting plate3012 that is configured to mountingly interface with theadaptor portion1240′ which is coupled to therobotic system1000 in the various manners described above. Thetool mounting portion3010 is configured to operably support atransmission arrangement3013 thereon. In at least one embodiment, theadaptor portion1240′ may be identical to theadaptor portion1240 described in detail above without the powered rotation bodies and disc members employed byadapter1240. In other embodiments, theadaptor portion1240′ may be identical toadaptor portion1240. Still other modifications which are considered to be within the spirit and scope of the various forms of the present invention may employ one or more of the mechanical motions (i.e., rotary motion(s)) from the tool holder portion1270 (as described hereinabove) to power/actuate thetransmission arrangement3013 while also employing one or more motors within thetool mounting portion3010 to power one or more other components of the surgical end effector. In addition, while the end effector of the depicted embodiment comprises an endocutter, those of ordinary skill in the art will understand that the unique and novel attributes of the depicted embodiment may be effectively employed in connection with other types of surgical end effectors without departing from the spirit and scope of various forms of the present invention.
In various embodiments, thetool mounting plate3012 is configured to at least house afirst firing motor3011 for supplying firing and retraction motions to theknife bar3003 which is coupled to or otherwise operably interfaces with thecutting instrument3002. Thetool mounting plate3012 has an array of electrical connectingpins3014 which are configured to interface with the slots1258 (FIG. 33) in theadapter1240′. Such arrangement permits thecontroller1001 of therobotic system1000 to provide control signals to theelectronic control circuit3020 of thesurgical tool3000. While the interface is described herein with reference to mechanical, electrical, and magnetic coupling elements, it should be understood that a wide variety of telemetry modalities might be used, including infrared, inductive coupling, or the like.
Control circuit3020 is shown in schematic form inFIG. 64. In one form or embodiment, thecontrol circuit3020 includes a power supply in the form of abattery3022 that is coupled to an on-off solenoid poweredswitch3024.Control circuit3020 further includes an on/off firingsolenoid3026 that is coupled to adouble pole switch3028 for controlling the rotational direction of themotor3011. Thus, when thecontroller1001 of therobotic system1000 supplies an appropriate control signal,switch3024 will permitbattery3022 to supply power to thedouble pole switch3028. Thecontroller1001 of therobotic system1000 will also supply an appropriate signal to thedouble pole switch3028 to supply power to themotor3011. When it is desired to fire the surgical end effector (i.e., drive the cuttinginstrument3002 distally through tissue clamped in the surgical end effector, thedouble pole switch3028 will be in a first position. When it is desired to retract thecutting instrument3002 to the starting position, thedouble pole switch3028 will be moved to the second position by thecontroller1001.
Various embodiments of thesurgical tool3000 also employ agear box3030 that is sized, in cooperation with afiring gear train3031 that, in at least one non-limiting embodiment, comprises afiring drive gear3032 that is in meshing engagement with a firing drivengear3034 for generating a desired amount of driving force necessary to drive the cuttinginstrument3002 through tissue and to drive and form staples in the various manners described herein. In the embodiment depicted inFIG. 61, the drivengear3034 is coupled to ascrew shaft3036 that is in threaded engagement with ascrew nut arrangement3038 that is constrained to move axially (represented by arrow “D”). Thescrew nut arrangement3038 is attached to thefiring bar3003. Thus, by rotating thescrew shaft3036 in a first direction, thecutting instrument3002 is driven in the distal direction “DD” and rotating the screw shaft in an opposite second direction, thecutting instrument3002 may be retracted in the proximal direction “PD”.
FIG. 65 illustrates a portion of anothersurgical tool3000′ that is substantially identical totool3000 described above, except that the drivengear3034 is attached to adrive shaft3040. Thedrive shaft3040 is attached to asecond driver gear3042 that is in meshing engagement with a third drivengear3044 that is in meshing engagement with ascrew3046 coupled to thefiring bar3003.
FIG. 66 illustrates anothersurgical tool3200 that may be effectively used in connection with arobotic system1000. In this embodiment, thesurgical tool3200 includes asurgical end effector3212 that in one non-limiting form, comprises a component portion that is selectively movable between first and second positions relative to at least one other end effector component portion. As will be discussed in further detail below, thesurgical tool3200 employs on-board motors for powering various components of atransmission arrangement3305. Thesurgical end effector3212 includes anelongated channel3222 that operably supports asurgical staple cartridge3234. Theelongated channel3222 has aproximal end3223 that slidably extends into a hollowelongated shaft assembly3208 that is coupled to atool mounting portion3300. In addition, thesurgical end effector3212 includes ananvil3224 that is pivotally coupled to theelongated channel3222 by a pair oftrunnions3225 that are received within correspondingopenings3229 in theelongated channel3222. Adistal end portion3209 of theshaft assembly3208 includes anopening3245 into which atab3227 on theanvil3224 is inserted in order to open theanvil3224 as theelongated channel3222 is moved axially in the proximal direction “PD” relative to thedistal end portion3209 of theshaft assembly3208. In various embodiments, a spring (not shown) may be employed to bias theanvil3224 to the open position.
As indicated above, thesurgical tool3200 includes atool mounting portion3300 that includes atool mounting plate3302 that is configured to operably support thetransmission arrangement3305 and to mountingly interface with theadaptor portion1240′ which is coupled to therobotic system1000 in the various manners described above. In at least one embodiment, theadaptor portion1240′ may be identical to theadaptor portion1240 described in detail above without the powered disc members employed byadapter1240. In other embodiments, theadaptor portion1240′ may be identical toadaptor portion1240. However, in such embodiments, because the various components of thesurgical end effector3212 are all powered by motor(s) in thetool mounting portion3300, thesurgical tool3200 will not employ or require any of the mechanical (i.e., non-electrical) actuation motions from thetool holder portion1270 to power thesurgical end effector3200 components. Still other modifications which are considered to be within the spirit and scope of the various forms of the present invention may employ one or more of the mechanical motions from the tool holder portion1270 (as described hereinabove) to power/actuate one or more of the surgical end effector components while also employing one or more motors within the tool mounting portion to power one or more other components of the surgical end effector.
In various embodiments, thetool mounting plate3302 is configured to support afirst firing motor3310 for supplying firing and retraction motions to thetransmission arrangement3305 to drive aknife bar3335 that is coupled to acutting instrument3332 of the type described above. As can be seen inFIG. 66, thetool mounting plate3212 has an array of electrical connectingpins3014 which are configured to interface with the slots1258 (FIG. 33) in theadapter1240′. Such arrangement permits thecontroller1001 of therobotic system1000 to provide control signals to theelectronic control circuits3320,3340 of thesurgical tool3200. While the interface is described herein with reference to mechanical, electrical, and magnetic coupling elements, it should be understood that a wide variety of telemetry modalities might be used, including infrared, inductive coupling, or the like.
In one form or embodiment, thefirst control circuit3320 includes a first power supply in the form of afirst battery3322 that is coupled to a first on-off solenoid poweredswitch3324. The firstfiring control circuit3320 further includes a first on/off firingsolenoid3326 that is coupled to a first double pole switch3328 for controlling the rotational direction of thefirst firing motor3310. Thus, when therobotic controller1001 supplies an appropriate control signal, thefirst switch3324 will permit thefirst battery3322 to supply power to the first double pole switch3328. Therobotic controller1001 will also supply an appropriate signal to the first double pole switch3328 to supply power to thefirst firing motor3310. When it is desired to fire the surgical end effector (i.e., drive the cuttinginstrument3232 distally through tissue clamped in thesurgical end effector3212, the first switch3328 will be positioned in a first position by therobotic controller1001. When it is desired to retract thecutting instrument3232 to the starting position, therobotic controller1001 will send the appropriate control signal to move the first switch3328 to the second position.
Various embodiments of thesurgical tool3200 also employ afirst gear box3330 that is sized, in cooperation with afiring drive gear3332 coupled thereto that operably interfaces with a firing gear train3333. In at least one non-limiting embodiment, the firing gear train333 comprises a firing drivengear3334 that is in meshing engagement withdrive gear3332, for generating a desired amount of driving force necessary to drive the cuttinginstrument3232 through tissue and to drive and form staples in the various manners described herein. In the embodiment depicted inFIG. 66, the drivengear3334 is coupled to adrive shaft3335 that has a second drivengear3336 coupled thereto. The second drivengear3336 is supported in meshing engagement with a third drivengear3337 that is in meshing engagement with a fourth drivengear3338. The fourth drivengear3338 is in meshing engagement with a threadedproximal portion3339 of theknife bar3235 that is constrained to move axially. Thus, by rotating thedrive shaft3335 in a first direction, thecutting instrument3232 is driven in the distal direction “DD” and rotating thedrive shaft3335 in an opposite second direction, thecutting instrument3232 may be retracted in the proximal direction “PD”.
As indicated above, the opening and closing of theanvil3224 is controlled by axially moving theelongated channel3222 relative to theelongated shaft assembly3208. The axial movement of theelongated channel3222 is controlled by aclosure control system3339. In various embodiments, theclosure control system3339 includes aclosure shaft3340 which has a hollow threadedend portion3341 that threadably engages a threadedclosure rod3342. The threadedend portion3341 is rotatably supported in aspine shaft3343 that operably interfaces with thetool mounting portion3300 and extends through a portion of theshaft assembly3208 as shown. Theclosure system3339 further comprises aclosure control circuit3350 that includes a second power supply in the form of asecond battery3352 that is coupled to a second on-off solenoid poweredswitch3354.Closure control circuit3350 further includes a second on/off firingsolenoid3356 that is coupled to a seconddouble pole switch3358 for controlling the rotation of asecond closure motor3360. Thus, when therobotic controller1001 supplies an appropriate control signal, thesecond switch3354 will permit thesecond battery3352 to supply power to the seconddouble pole switch3354. Therobotic controller1001 will also supply an appropriate signal to the seconddouble pole switch3358 to supply power to thesecond motor3360. When it is desired to close theanvil3224, the second switch3348 will be in a first position. When it is desired to open theanvil3224, the second switch3348 will be moved to a second position.
Various embodiments oftool mounting portion3300 also employ asecond gear box3362 that is coupled to aclosure drive gear3364. Theclosure drive gear3364 is in meshing engagement with aclosure gear train3363. In various non-limiting forms, theclosure gear train3363 includes a closure drivengear3365 that is attached to a closure drive shaft3366. Also attached to the closure drive shaft3366 is aclosure drive gear3367 that is in meshing engagement with aclosure shaft gear3360 attached to theclosure shaft3340.FIG. 66 depicts theend effector3212 in the open position. As indicated above, when the threadedclosure rod3342 is in the position depicted inFIG. 66, a spring (not shown) biases theanvil3224 to the open position. When it is desired to close theanvil3224, therobotic controller1001 will activate thesecond motor3360 to rotate theclosure shaft3340 to draw the threadedclosure rod3342 and thechannel3222 in the proximal direction ‘PD’. As theanvil3224 contacts thedistal end portion3209 of theshaft3208, theanvil3224 is pivoted to the closed position.
A method of operating thesurgical tool3200 will now be described. Once thetool mounting portion3302 has be operably coupled to thetool holder1270 of therobotic system1000, therobotic system1000 can orient theend effector3212 in position adjacent the target tissue to be cut and stapled. If theanvil3224 is not already in the open position, therobotic controller1001 may activate thesecond closure motor3360 to drive thechannel3222 in the distal direction to the position depicted inFIG. 66. Once therobotic controller1001 determines that thesurgical end effector3212 is in the open position by sensor(s) in the and effector and/or thetool mounting portion3300, therobotic controller1001 may provide the surgeon with a signal to inform the surgeon that theanvil3224 may then be closed. Once the target tissue is positioned between theopen anvil3224 and thesurgical staple cartridge3234, the surgeon may then commence the closure process by activating therobotic controller1001 to apply a closure control signal to thesecond closure motor3360. Thesecond closure motor3360 applies a rotary motion to theclosure shaft3340 to draw thechannel3222 in the proximal direction “PD” until theanvil3224 has been pivoted to the closed position. Once therobotic controller1001 determines that theanvil3224 has been moved to the closed position by sensor(s) in thesurgical end effector3212 and/or in thetool mounting portion3300 that are in communication with the robotic control system, themotor3360 may be deactivated. Thereafter, the firing process may be commenced either manually by the surgeon activating a trigger, button, etc. on thecontroller1001 or thecontroller1001 may automatically commence the firing process.
To commence the firing process, therobotic controller1001 activates the firingmotor3310 to drive the firingbar3235 and thecutting instrument3232 in the distal direction “DD”. Oncerobotic controller1001 has determined that thecutting instrument3232 has moved to the ending position within thesurgical staple cartridge3234 by means of sensors in thesurgical end effector3212 and/or themotor drive portion3300, therobotic controller1001 may provide the surgeon with an indication signal. Thereafter the surgeon may manually activate thefirst motor3310 to retract thecutting instrument3232 to the starting position or therobotic controller1001 may automatically activate thefirst motor3310 to retract thecutting element3232.
The embodiment depicted inFIG. 66 does not include an articulation joint.FIGS. 67 and 68 illustratesurgical tools3200′ and 3200″ that haveend effectors3212′,3212″, respectively that may be employed with an elongated shaft embodiment that has an articulation joint of the various types disclosed herein. For example, as can be seen inFIG. 64, a threadedclosure shaft3342 is coupled to theproximal end3223 of theelongated channel3222 by a flexible cable or otherflexible member3345. The location of an articulation joint (not shown) within theelongated shaft assembly3208 will coincide with theflexible member3345 to enable theflexible member3345 to accommodate such articulation. In addition, in the above-described embodiment, the flexible member33345 is rotatably affixed to theproximal end portion3223 of theelongated channel3222 to enable theflexible member3345 to rotate relative thereto to prevent theflexible member3229 from “winding up” relative to thechannel3222. Although not shown, the cutting element may be driven in one of the above described manners by a knife bar that can also accommodate articulation of the elongated shaft assembly.FIG. 68 depicts asurgical end effector3212″ that is substantially identical to thesurgical end effector3212 described above, except that the threadedclosure rod3342 is attached to aclosure nut3347 that is constrained to only move axially within theelongated shaft assembly3208. Theflexible member3345 is attached to theclosure nut3347. Such arrangement also prevents the threadedclosure rod3342 from winding-up theflexible member3345. Aflexible knife bar3235′ may be employed to facilitate articulation of thesurgical end effector3212″.
Thesurgical tools3200,3200′, and3200″ described above may also employ anyone of the cutting instrument embodiments described herein. As described above, the anvil of each of the end effectors of these tools is closed by drawing the elongated channel into contact with the distal end of the elongated shaft assembly. Thus, once the target tissue has been located between thestaple cartridge3234 and theanvil3224, therobotic controller1001 can start to draw thechannel3222 inward into theshaft assembly3208. In various embodiments, however, to prevent theend effector3212,3212′,3212″ from moving the target tissue with the end effector during this closing process, thecontroller1001 may simultaneously move the tool holder and ultimately the tool such to compensate for the movement of theelongated channel3222 so that, in effect, the target tissue is clamped between the anvil and the elongated channel without being otherwise moved.
FIGS. 69-71 depict anothersurgical tool embodiment3201 that is substantially identical tosurgical tool3200″ described above, except for the differences discussed below. In this embodiment, the threadedclosure rod3342′ has variable pitched grooves. More specifically, as can be seen inFIG. 70, theclosure rod3342′ has adistal groove section3380 and aproximal groove section3382. The distal andproximal groove sections3380,3382 are configured for engagement with alug3390 supported within the hollow threadedend portion3341′. As can be seen inFIG. 70, thedistal groove section3380 has a finer pitch than thegroove section3382. Thus, such variable pitch arrangement permits theelongated channel3222 to be drawn into theshaft3208 at a first speed or rate by virtue of the engagement between thelug3390 and theproximal groove segment3382. When thelug3390 engages the distal groove segment, thechannel3222 will be drawn into theshaft3208 at a second speed or rate. Because theproximal groove segment3382 is coarser than thedistal groove segment3380, the first speed will be greater than the second speed. Such arrangement serves to speed up the initial closing of the end effector for tissue manipulation and then after the tissue has been properly positioned therein, generate the amount of closure forces to properly clamp the tissue for cutting and sealing. Thus, theanvil3234 initially closes fast with a lower force and then applies a higher closing force as the anvil closes more slowly.
The surgical end effector opening and closing motions are employed to enable the user to use the end effector to grasp and manipulate tissue prior to fully clamping it in the desired location for cutting and sealing. The user may, for example, open and close the surgical end effector numerous times during this process to orient the end effector in a proper position which enables the tissue to be held in a desired location. Thus, in at least some embodiments, to produce the high loading for firing, the fine thread may require as many as 5-10 full rotations to generate the necessary load. In some cases, for example, this action could take as long as 2-5 seconds. If it also took an equally long time to open and close the end effector each time during the positioning/tissue manipulation process, just positioning the end effector may take an undesirably long time. If that happens, it is possible that a user may abandon such use of the end effector for use of a conventional grasper device. Use of graspers, etc. may undesirably increase the costs associated with completing the surgical procedure.
The above-described embodiments employ a battery or batteries to power the motors used to drive the end effector components. Activation of the motors is controlled by therobotic system1000. In alternative embodiments, the power supply may comprise alternating current “AC” that is supplied to the motors by therobotic system1000. That is, the AC power would be supplied from the system powering therobotic system1000 through the tool holder and adapter. In still other embodiments, a power cord or tether may be attached to thetool mounting portion3300 to supply the requisite power from a separate source of alternating or direct current.
In use, thecontroller1001 may apply an initial rotary motion to the closure shaft3340 (FIG. 66) to draw theelongated channel3222 axially inwardly into theelongated shaft assembly3208 and move the anvil from a first position to an intermediate position at a first rate that corresponds with the point wherein thedistal groove section3380 transitions to theproximal groove section3382. Further application of rotary motion to theclosure shaft3340 will cause the anvil to move from the intermediate position to the closed position relative to the surgical staple cartridge. When in the closed position, the tissue to be cut and stapled is properly clamped between the anvil and the surgical staple cartridge.
FIGS. 72-75 illustrate anothersurgical tool embodiment3400 of the present invention. This embodiment includes anelongated shaft assembly3408 that extends from atool mounting portion3500. Theelongated shaft assembly3408 includes a rotatable proximalclosure tube segment3410 that is rotatably journaled on aproximal spine member3420 that is rigidly coupled to atool mounting plate3502 of thetool mounting portion3500. Theproximal spine member3420 has adistal end3422 that is coupled to anelongated channel portion3522 of asurgical end effector3412. For example, in at least one embodiment, theelongated channel portion3522 has adistal end portion3523 that “hookingly engages” thedistal end3422 of thespine member3420. Theelongated channel3522 is configured to support asurgical staple cartridge3534 therein. This embodiment may employ one of the various cutting instrument embodiments disclosed herein to sever tissue that is clamped in thesurgical end effector3412 and fire the staples in thestaple cartridge3534 into the severed tissue.
Surgical end effector3412 has ananvil3524 that is pivotally coupled to theelongated channel3522 by a pair oftrunnions3525 that are received in correspondingopenings3529 in theelongated channel3522. Theanvil3524 is moved between the open (FIG. 72) and closed positions (FIGS. 73-75) by a distalclosure tube segment3430. Adistal end portion3432 of the distalclosure tube segment3430 includes anopening3445 into which atab3527 on theanvil3524 is inserted in order to open and close theanvil3524 as the distalclosure tube segment3430 moves axially relative thereto. In various embodiments, theopening3445 is shaped such that as theclosure tube segment3430 is moved in the proximal direction, theclosure tube segment3430 causes theanvil3524 to pivot to an open position. In addition or in the alternative, a spring (not shown) may be employed to bias theanvil3524 to the open position.
As can be seen inFIGS. 72-75, the distalclosure tube segment3430 includes alug3442 that extends from itsdistal end3440 into threaded engagement with a variable pitch groove/thread3414 formed in thedistal end3412 of the rotatable proximalclosure tube segment3410. The variable pitch groove/thread3414 has adistal section3416 and aproximal section3418. The pitch of the distal groove/thread section3416 is finer than the pitch of the proximal groove/thread section3418. As can also be seen inFIGS. 72-75, the distalclosure tube segment3430 is constrained for axial movement relative to thespine member3420 by anaxial retainer pin3450 that is received in anaxial slot3424 in the distal end of thespine member3420.
As indicated above, theanvil2524 is open and closed by rotating the proximalclosure tube segment3410. The variable pitch thread arrangement permits the distalclosure tube segment3430 to be driven in the distal direction “DD” at a first speed or rate by virtue of the engagement between thelug3442 and the proximal groove/thread section3418. When thelug3442 engages the distal groove/thread section3416, the distalclosure tube segment3430 will be driven in the distal direction at a second speed or rate. Because the proximal groove/thread section3418 is coarser than the distal groove/thread segment3416, the first speed will be greater than the second speed.
In at least one embodiment, thetool mounting portion3500 is configured to receive a corresponding first rotary motion from therobotic controller1001 and convert that first rotary motion to a primary rotary motion for rotating the rotatable proximalclosure tube segment3410 about a longitudinal tool axis LT-LT. As can be seen inFIG. 76, aproximal end3460 of the proximalclosure tube segment3410 is rotatably supported within acradle arrangement3504 attached to atool mounting plate3502 of thetool mounting portion3500. Arotation gear3462 is formed on or attached to theproximal end3460 of theclosure tube segment3410 for meshing engagement with arotation drive assembly3470 that is operably supported on thetool mounting plate3502. In at least one embodiment, arotation drive gear3472 is coupled to a corresponding first one of the driven discs orelements1304 on the adapter side of thetool mounting plate3502 when thetool mounting portion3500 is coupled to thetool holder1270. SeeFIGS. 34 and 76. Therotation drive assembly3470 further comprises a rotary drivengear3474 that is rotatably supported on thetool mounting plate3502 in meshing engagement with therotation gear3462 and therotation drive gear3472. Application of a first rotary control motion from therobotic controller1001 through thetool holder1270 and theadapter1240 to the corresponding drivenelement1304 will thereby cause rotation of therotation drive gear3472 by virtue of being operably coupled thereto. Rotation of therotation drive gear3472 ultimately results in the rotation of theclosure tube segment3410 to open and close theanvil3524 as described above.
As indicated above, thesurgical end effector3412 employs a cutting instrument of the type and constructions described above.FIG. 76 illustrates one form ofknife drive assembly3480 for axially advancing aknife bar3492 that is attached to such cutting instrument. One form of theknife drive assembly3480 comprises arotary drive gear3482 that is coupled to a corresponding third one of the driven discs orelements1304 on the adapter side of thetool mounting plate3502 when thetool drive portion3500 is coupled to thetool holder1270. SeeFIGS. 34 and 76. Theknife drive assembly3480 further comprises a first rotary drivengear assembly3484 that is rotatably supported on thetool mounting plate5200. The first rotary drivengear assembly3484 is in meshing engagement with a third rotary drivengear assembly3486 that is rotatably supported on thetool mounting plate3502 and which is in meshing engagement with a fourth rotary drivengear assembly3488 that is in meshing engagement with a threadedportion3494 ofdrive shaft assembly3490 that is coupled to theknife bar3492. Rotation of therotary drive gear3482 in a second rotary direction will result in the axial advancement of thedrive shaft assembly3490 andknife bar3492 in the distal direction “DD”. Conversely, rotation of therotary drive gear3482 in a secondary rotary direction (opposite to the second rotary direction) will cause thedrive shaft assembly3490 and theknife bar3492 to move in the proximal direction.
FIGS. 77-86 illustrate anothersurgical tool3600 embodiment of the present invention that may be employed in connection with arobotic system1000. As can be seen inFIG. 77, thetool3600 includes an end effector in the form of adisposable loading unit3612. Various forms of disposable loading units that may be employed in connection withtool3600 are disclosed, for example, in U.S. Patent Application Publication No.US 2009/0206131 A1, entitled “End Effector Arrangements For a Surgical Cutting and Stapling Instrument”, the disclosure of which is herein incorporated by reference in its entirety.
In at least one form, thedisposable loading unit3612 includes ananvil assembly3620 that is supported for pivotal travel relative to acarrier3630 that operably supports astaple cartridge3640 therein. A mountingassembly3650 is pivotally coupled to thecartridge carrier3630 to enable thecarrier3630 to pivot about an articulation axis AA-AA relative to a longitudinal tool axis LT-LT. Referring toFIG. 82, mountingassembly3650 includes upper andlower mounting portions3652 and3654. Each mounting portion includes a threadedbore3656 on each side thereof dimensioned to receive threaded bolts (not shown) for securing the proximal end ofcarrier3630 thereto. A pair of centrally locatedpivot members3658 extends between upper and lower mounting portions via a pair ofcoupling members3660 which engage a distal end of ahousing portion3662. Couplingmembers3660 each include an interlockingproximal portion3664 configured to be received ingrooves3666 formed in the proximal end ofhousing portion3662 to retain mountingassembly3650 andhousing portion3662 in a longitudinally fixed position in relation thereto.
In various forms,housing portion3662 of disposable loading unit3614 includes anupper housing half3670 and alower housing half3672 contained within anouter casing3674. The proximal end ofhousing half3670 includesengagement nubs3676 for releasably engaging anelongated shaft3700 and aninsertion tip3678. Nubs3676 form a bayonet-type coupling with the distal end of theelongated shaft3700 which will be discussed in further detail below.Housing halves3670,3672 define achannel3674 for slidably receivingaxial drive assembly3680. Asecond articulation link3690 is dimensioned to be slidably positioned within aslot3679 formed betweenhousing halves3670,3672. A pair of blow outplates3691 are positioned adjacent the distal end ofhousing portion3662 adjacent the distal end ofaxial drive assembly3680 to prevent outward bulging ofdrive assembly3680 during articulation ofcarrier3630.
In various embodiments, thesecond articulation link3690 includes at least one elongated metallic plate. Preferably, two or more metallic plates are stacked to formlink3690. The proximal end ofarticulation link3690 includes ahook portion3692 configured to engagefirst articulation link3710 extending through theelongated shaft3700. The distal end of thesecond articulation link3690 includes aloop3694 dimensioned to engage a projection formed on mountingassembly3650. The projection is laterally offset frompivot pin3658 such that linear movement ofsecond articulation link3690causes mounting assembly3650 to pivot aboutpivot pins3658 to articulate thecarrier3630.
In various forms,axial drive assembly3680 includes anelongated drive beam3682 including adistal working head3684 and aproximal engagement section3685.Drive beam3682 may be constructed from a single sheet of material or, preferably, multiple stacked sheets.Engagement section3685 includes a pair of engagement fingers which are dimensioned and configured to mountingly engage a pair of corresponding retention slots formed indrive member3686.Drive member3686 includes aproximal porthole3687 configured to receive thedistal end3722 of control rod2720 (SeeFIG. 86) when the proximal end of disposable loading unit3614 is engaged withelongated shaft3700 ofsurgical tool3600.
Referring toFIGS. 77 and 84-86, to use thesurgical tool3600, adisposable loading unit3612 is first secured to the distal end ofelongated shaft3700. It will be appreciated that thesurgical tool3600 may include an articulating or a non-articulating disposable loading unit. To secure thedisposable loading unit3612 to theelongated shaft3700, thedistal end3722 ofcontrol rod3720 is inserted intoinsertion tip3678 ofdisposable loading unit3612, andinsertion tip3678 is slid longitudinally into the distal end of theelongated shaft3700 in the direction indicated by arrow “A” inFIG. 84 such thathook portion3692 ofsecond articulation link3690 slides within achannel3702 in theelongated shaft3700. Nubs3676 will each be aligned in a respective channel (not shown) inelongated shaft3700. Whenhook portion3692 engages theproximal wall3704 ofchannel3702,disposable loading unit3612 is rotated in the direction indicated by arrow “B” inFIGS. 83 and 84 to movehook portion3692 ofsecond articulation link3690 into engagement withfinger3712 offirst articulation link3710. Nubs3676 also form a “bayonet-type” coupling withinannular channel3703 in theelongated shaft3700. During rotation ofloading unit3612,nubs3676 engage cam surface3732 (FIG. 84) ofblock plate3730 to initially moveplate3730 in the direction indicated by arrow “C” inFIG. 84 to lockengagement member3734 inrecess3721 ofcontrol rod3720 to prevent longitudinal movement ofcontrol rod3720 during attachment ofdisposable loading unit3612. During the final degree of rotation,nubs3676 disengage fromcam surface3732 to allow blockingplate3730 to move in the direction indicated by arrow “D” inFIGS. 83 and 86 from behindengagement member3734 to once again permit longitudinal movement ofcontrol rod3720. While the above-described attachment method reflects that thedisposable loading unit3612 is manipulated relative to theelongated shaft3700, the person of ordinary skill in the art will appreciate that thedisposable loading unit3612 may be supported in a stationary position and therobotic system1000 may manipulate theelongated shaft portion3700 relative to thedisposable loading unit3612 to accomplish the above-described coupling procedure.
FIG. 87 illustrates anotherdisposable loading unit3612′ that is attachable in a bayonet-type arrangement with theelongated shaft3700′ that is substantially identical toshaft3700 except for the differences discussed below. As can be seen inFIG. 87, theelongated shaft3700′ hasslots3705 that extend for at least a portion thereof and which are configured to receivenubs3676 therein. In various embodiments, thedisposable loading unit3612′ includesarms3677 extending therefrom which, prior to the rotation ofdisposable loading unit3612′, can be aligned, or at least substantially aligned, withnubs3676 extending fromhousing portion3662. In at least one embodiment,arms3677 andnubs3676 can be inserted intoslots3705 inelongated shaft3700′, for example, whendisposable loading unit3612′ is inserted into elongatedshaft3700′. Whendisposable loading unit3612′ is rotated,arms3677 can be sufficiently confined withinslots3705 such thatslots3705 can hold them in position, whereasnubs3676 can be positioned such that they are not confined withinslots3705 and can be rotated relative toarms3677. When rotated, thehook portion3692 of thearticulation link3690 is engaged with thefirst articulation link3710 extending through theelongated shaft3700′.
Other methods of coupling the disposable loading units to the end of the elongated shaft may be employed. For example, as shown inFIGS. 88 and 89,disposable loading unit3612″ can includeconnector portion3613 which can be configured to be engaged withconnector portion3740 of theelongated shaft3700″. In at least one embodiment,connector portion3613 can include at least one projection and/or groove which can be mated with at least one projection and/or groove ofconnector portion3740. In at least one such embodiment, the connector portions can include co-operating dovetail portions. In various embodiments, the connector portions can be configured to interlock with one another and prevent, or at least inhibit, distal and/or proximal movement ofdisposable loading unit3612″ alongaxis3741. In at least one embodiment, the distal end of theaxial drive assembly3680′ can includeaperture3681 which can be configured to receiveprojection3721 extending fromcontrol rod3720′. In various embodiments, such an arrangement can allowdisposable loading unit3612″ to be assembled toelongated shaft3700 in a direction which is not collinear with or parallel toaxis3741. Although not illustrated,axial drive assembly3680′ andcontrol rod3720 can include any other suitable arrangement of projections and apertures to operably connect them to each other. Also in this embodiment, thefirst articulation link3710 which can be operably engaged withsecond articulation link3690.
As can be seen inFIGS. 77 and 90, thesurgical tool3600 includes atool mounting portion3750. Thetool mounting portion3750 includes atool mounting plate3751 that is configured for attachment to thetool drive assembly1010. The tool mounting portion operably supported atransmission arrangement3752 thereon. In use, it may be desirable to rotate thedisposable loading unit3612 about the longitudinal tool axis defined by theelongated shaft3700. In at least one embodiment, thetransmission arrangement3752 includes arotational transmission assembly3753 that is configured to receive a corresponding rotary output motion from thetool drive assembly1010 of therobotic system1000 and convert that rotary output motion to a rotary control motion for rotating the elongated shaft3700 (and the disposable loading unit3612) about the longitudinal tool axis LT-LT. As can be seen inFIG. 90, aproximal end3701 of theelongated shaft3700 is rotatably supported within acradle arrangement3754 that is attached to thetool mounting plate3751 of thetool mounting portion3750. Arotation gear3755 is formed on or attached to theproximal end3701 of theelongated shaft3700 for meshing engagement with arotation gear assembly3756 operably supported on thetool mounting plate3751. In at least one embodiment, arotation drive gear3757 drivingly coupled to a corresponding first one of the driven discs orelements1304 on the adapter side of thetool mounting plate3751 when thetool mounting portion3750 is coupled to thetool drive assembly1010. Therotation transmission assembly3753 further comprises a rotary driven gear3758 that is rotatably supported on thetool mounting plate3751 in meshing engagement with therotation gear3755 and therotation drive gear3757. Application of a first rotary output motion from therobotic system1000 through thetool drive assembly1010 to the corresponding drivenelement1304 will thereby cause rotation of therotation drive gear3757 by virtue of being operably coupled thereto. Rotation of therotation drive gear3757 ultimately results in the rotation of the elongated shaft3700 (and the disposable loading unit3612) about the longitudinal tool axis LT-LT (primary rotary motion).
As can be seen inFIG. 90, adrive shaft assembly3760 is coupled to a proximal end of thecontrol rod2720. In various embodiments, thecontrol rod2720 is axially advanced in the distal and proximal directions by a knife/closure drive transmission3762. One form of the knife/closure drive assembly3762 comprises arotary drive gear3763 that is coupled to a corresponding second one of the driven rotatable body portions, discs orelements1304 on the adapter side of thetool mounting plate3751 when thetool mounting portion3750 is coupled to thetool holder1270. The rotary drivengear3763 is in meshing driving engagement with a gear train, generally depicted as3764. In at least one form, thegear train3764 further comprises a first rotary drivengear assembly3765 that is rotatably supported on thetool mounting plate3751. The first rotary drivengear assembly3765 is in meshing engagement with a second rotary drivengear assembly3766 that is rotatably supported on thetool mounting plate3751 and which is in meshing engagement with a third rotary drivengear assembly3767 that is in meshing engagement with a threaded portion3768 of thedrive shaft assembly3760. Rotation of therotary drive gear3763 in a second rotary direction will result in the axial advancement of thedrive shaft assembly3760 andcontrol rod2720 in the distal direction “DD”. Conversely, rotation of therotary drive gear3763 in a secondary rotary direction which is opposite to the second rotary direction will cause thedrive shaft assembly3760 and thecontrol rod2720 to move in the proximal direction. When thecontrol rod2720 moves in the distal direction, it drives thedrive beam3682 and the workinghead3684 thereof distally through thesurgical staple cartridge3640. As the workinghead3684 is driven distally, it operably engages theanvil3620 to pivot it to a closed position.
Thecartridge carrier3630 may be selectively articulated about articulation axis AA-AA by applying axial articulation control motions to the first andsecond articulation links3710 and3690. In various embodiments, thetransmission arrangement3752 further includes anarticulation drive3770 that is operably supported on thetool mounting plate3751. More specifically and with reference toFIG. 90, it can be seen that aproximal end portion3772 of anarticulation drive shaft3771 configured to operably engage with thefirst articulation link3710 extends through therotation gear3755 and is rotatably coupled to ashifter rack gear3774 that is slidably affixed to thetool mounting plate3751 throughslots3775. Thearticulation drive3770 further comprises ashifter drive gear3776 that is coupled to a corresponding third one of the driven discs orelements1304 on the adapter side of thetool mounting plate3751 when thetool mounting portion3750 is coupled to thetool holder1270. Thearticulation drive assembly3770 further comprises a shifter drivengear3778 that is rotatably supported on thetool mounting plate3751 in meshing engagement with theshifter drive gear3776 and theshifter rack gear3774. Application of a third rotary output motion from therobotic system1000 through thetool drive assembly1010 to the corresponding drivenelement1304 will thereby cause rotation of theshifter drive gear3776 by virtue of being operably coupled thereto. Rotation of theshifter drive gear3776 ultimately results in the axial movement of theshifter gear rack3774 and thearticulation drive shaft3771. The direction of axial travel of thearticulation drive shaft3771 depends upon the direction in which theshifter drive gear3776 is rotated by therobotic system1000. Thus, rotation of theshifter drive gear3776 in a first rotary direction will result in the axial movement of thearticulation drive shaft3771 in the proximal direction “PD” and cause thecartridge carrier3630 to pivot in a first direction about articulation axis AA-AA. Conversely, rotation of theshifter drive gear3776 in a second rotary direction (opposite to the first rotary direction) will result in the axial movement of thearticulation drive shaft3771 in the distal direction “DD” to thereby cause thecartridge carrier3630 to pivot about articulation axis AA-AA in an opposite direction.
FIG. 91 illustrates yet anothersurgical tool3800 embodiment of the present invention that may be employed with arobotic system1000. As can be seen inFIG. 91, thesurgical tool3800 includes asurgical end effector3812 in the form of anendocutter3814 that employs various cable-driven components. Various forms of cable driven endocutters are disclosed, for example, in U.S. Pat. No. 7,726,537, entitled “Surgical Stapler With Universal Articulation and Tissue Pre-Clamp” and U.S. Patent Application Publication No. 2008/0308603A1, entitled “Cable Driven Surgical Stapling and Cutting Instrument With Improved Cable Attachment Arrangements”, the disclosures of each are herein incorporated by reference in their respective entireties.Such endocutters3814 may be referred to as a “disposable loading unit” because they are designed to be disposed of after a single use. However, the various unique and novel arrangements of various embodiments of the present invention may also be employed in connection with cable driven end effectors that are reusable.
As can be seen inFIG. 91, in at least one form, theendocutter3814 includes anelongated channel3822 that operably supports asurgical staple cartridge3834 therein. Ananvil3824 is pivotally supported for movement relative to thesurgical staple cartridge3834. Theanvil3824 has acam surface3825 that is configured for interaction with apreclamping collar3840 that is supported for axial movement relative thereto. Theend effector3814 is coupled to anelongated shaft assembly3808 that is attached to atool mounting portion3900. In various embodiments, aclosure cable3850 is employed to movepre-clamping collar3840 distally onto and overcam surface3825 to close theanvil3824 relative to thesurgical staple cartridge3834 and compress the tissue therebetween. Preferably,closure cable3850 attaches to thepre-clamping collar3840 at ornear point3841 and is fed through a passageway in anvil3824 (or under a proximal portion of anvil3824) and fed proximally throughshaft3808. Actuation ofclosure cable3850 in the proximal direction “PD” forcespre-clamping collar3840 distally againstcam surface3825 to closeanvil3824 relative tostaple cartridge assembly3834. A return mechanism, e.g., a spring, cable system or the like, may be employed to returnpre-clamping collar3840 to a pre-clamping orientation which re-opens theanvil3824.
Theelongated shaft assembly3808 may be cylindrical in shape and define achannel3811 which may be dimensioned to receive atube adapter3870. SeeFIG. 92. In various embodiments, thetube adapter3870 may be slidingly received in friction-fit engagement with the internal channel ofelongated shaft3808. The outer surface of thetube adapter3870 may further include at least one mechanical interface, e.g., a cutout ornotch3871, oriented to mate with a corresponding mechanical interface, e.g., a radially inwardly extending protrusion or detent (not shown), disposed on the inner periphery ofinternal channel3811 to lock thetube adapter3870 to theelongated shaft3808. In various embodiments, the distal end oftube adapter3870 may include a pair of opposingflanges3872aand3872bwhich define a cavity for pivotably receiving apivot block3873 therein. Eachflange3872aand3872bmay include anaperture3874aand3874bthat is oriented to receive apivot pin3875 that extends through an aperture inpivot block3873 to allow pivotable movement ofpivot block3873 about an axis that is perpendicular to longitudinal tool axis “LT-LT”. Thechannel3822 may be formed with two upwardly extending flanges3823a,3823bthat have apertures therein, which are dimensioned to receive apivot pin3827. In turn,pivot pin3875 mounts through apertures inpivot block3873 to permit rotation of thesurgical end effector3814 about the “Y” axis as needed during a given surgical procedure. Rotation ofpivot block3873 aboutpin3875 along “Z” axis rotates thesurgical end effector3814 about the “Z” axis. SeeFIG. 92. Other methods of fastening theelongated channel3822 to thepivot block3873 may be effectively employed without departing from the spirit and scope of the present invention.
Thesurgical staple cartridge3834 can be assembled and mounted within theelongated channel3822 during the manufacturing or assembly process and sold as part of thesurgical end effector3812, or thesurgical staple cartridge3834 may be designed for selective mounting within theelongated channel3822 as needed and sold separately, e.g., as a single use replacement, replaceable or disposable staple cartridge assembly. It is within the scope of this disclosure that thesurgical end effector3812 may be pivotally, operatively, or integrally attached, for example, todistal end3809 of theelongated shaft assembly3808 of a disposable surgical stapler. As is known, a used or spentdisposable loading unit3814 can be removed from theelongated shaft assembly3808 and replaced with an unused disposable unit. Theendocutter3814 may also preferably include an actuator, preferably adynamic clamping member3860, asled3862, as well as staple pushers (not shown) and staples (not shown) once an unspent orunused cartridge3834 is mounted in theelongated channel3822. SeeFIG. 92.
In various embodiments, thedynamic clamping member3860 is associated with, e.g., mounted on and rides on, or with or is connected to or integral with and/or rides behindsled3862. It is envisioned thatdynamic clamping member3860 can have cam wedges or cam surfaces attached or integrally formed or be pushed by a leading distal surface thereof. In various embodiments,dynamic clamping member3860 may include an upper portion3863 having atransverse aperture3864 with a pin3865 mountable or mounted therein, a central support or upward extension3866 and substantially T-shapedbottom flange3867 which cooperate to slidingly retaindynamic clamping member3860 along an ideal cutting path during longitudinal, distal movement ofsled3862. The leadingcutting edge3868, here,knife blade3869, is dimensioned to ride withinslot3835 ofstaple cartridge assembly3834 and separate tissue once stapled. As used herein, the term “knife assembly” may include the aforementioneddynamic clamping member3860,knife3869, andsled3862 or other knife/beam/sled drive arrangements and cutting instrument arrangements. In addition, the various embodiments of the present invention may be employed with knife assembly/cutting instrument arrangements that may be entirely supported in thestaple cartridge3834 or partially supported in thestaple cartridge3834 andelongated channel3822 or entirely supported within theelongated channel3822.
In various embodiments, thedynamic clamping member3860 may be driven in the proximal and distal directions by acable drive assembly3870. In one non-limiting form, the cable drive assembly comprises a pair ofadvance cables3880,3882 and afiring cable3884.FIGS. 93 and 94 illustrate thecables3880,3882,3884 in diagrammatic form. As can be seen in those Figures, afirst advance cable3880 is operably supported on a first distalcable transition support3885 which may comprise, for example, a pulley, rod, capstan, etc. that is attached to the distal end of theelongated channel3822 and a first proximalcable transition support3886 which may comprise, for example, a pulley, rod, capstan, etc. that is operably supported by theelongated channel3822. Adistal end3881 of thefirst advance cable3880 is affixed to thedynamic clamping assembly3860. Thesecond advance cable3882 is operably supported on a second distalcable transition support3887 which may, for example, comprise a pulley, rod, capstan etc. that is mounted to the distal end of theelongated channel3822 and a second proximalcable transition support3888 which may, for example, comprise a pulley, rod, capstan, etc. mounted to the proximal end of theelongated channel3822. Theproximal end3883 of thesecond advance cable3882 may be attached to thedynamic clamping assembly3860. Also in these embodiments, anendless firing cable3884 is employed and journaled on asupport3889 that may comprise a pulley, rod, capstan, etc. mounted within theelongated shaft3808. In one embodiment, the retractcable3884 may be formed in a loop and coupled to aconnector3889′ that is fixedly attached to the first andsecond advance cables3880,3882.
Various non-limiting embodiments of the present invention include acable drive transmission3920 that is operably supported on atool mounting plate3902 of thetool mounting portion3900. Thetool mounting portion3900 has an array of electrical connectingpins3904 which are configured to interface with the slots1258 (FIG. 33) in theadapter1240′. Such arrangement permits therobotic system1000 to provide control signals to acontrol circuit3910 of thetool3800. While the interface is described herein with reference to mechanical, electrical, and magnetic coupling elements, it should be understood that a wide variety of telemetry modalities might be used, including infrared, inductive coupling, or the like.
Control circuit3910 is shown in schematic form inFIG. 91. In one form or embodiment, thecontrol circuit3910 includes a power supply in the form of abattery3912 that is coupled to an on-off solenoid poweredswitch3914. In other embodiments, however, the power supply may comprise a source of alternating current.Control circuit3910 further includes an on/offsolenoid3916 that is coupled to adouble pole switch3918 for controlling motor rotation direction. Thus, when therobotic system1000 supplies an appropriate control signal,switch3914 will permitbattery3912 to supply power to thedouble pole switch3918. Therobotic system1000 will also supply an appropriate signal to thedouble pole switch3918 to supply power to ashifter motor3922.
Turning toFIGS. 95-100, at least one embodiment of thecable drive transmission3920 comprises adrive pulley3930 that is operably mounted to adrive shaft3932 that is attached to a drivenelement1304 of the type and construction described above that is designed to interface with acorresponding drive element1250 of theadapter1240. SeeFIGS. 33 and 98. Thus, when thetool mounting portion3900 is operably coupled to thetool holder1270, therobot system1000 can apply rotary motion to the drivepulley3930 in a desired direction. A first drive member orbelt3934 drivingly engages thedrive pulley3930 and asecond drive shaft3936 that is rotatably supported on ashifter yoke3940. Theshifter yoke3940 is operably coupled to theshifter motor3922 such that rotation of theshaft3923 of theshifter motor3922 in a first direction will shift the shifter yoke in a first direction “FD” and rotation of theshifter motor shaft3923 in a second direction will shift theshifter yoke3940 in a second direction “SD”. Other embodiments of the present invention may employ a shifter solenoid arrangement for shifting the shifter yoke in said first and second directions.
As can be seen inFIGS. 95-98, aclosure drive gear3950 mounted to asecond drive shaft3936 and is configured to selectively mesh with a closure drive assembly, generally designated as3951. Likewise afiring drive gear3960 is also mounted to thesecond drive shaft3936 and is configured to selectively mesh with a firing drive assembly generally designated as3961. Rotation of thesecond drive shaft3936 causes theclosure drive gear3950 and thefiring drive gear3960 to rotate. In one non-limiting embodiment, theclosure drive assembly3951 comprises a closure drivengear3952 that is coupled to afirst closure pulley3954 that is rotatably supported on athird drive shaft3956. Theclosure cable3850 is drivingly received on thefirst closure pulley3954 such that rotation of the closure drivengear3952 will drive theclosure cable3850. Likewise, the firingdrive assembly3961 comprises a firing drivengear3962 that is coupled to a first firingpulley3964 that is rotatably supported on thethird drive shaft3956. The first and second driving pulleys3954 and3964 are independently rotatable on thethird drive shaft3956. The firingcable3884 is drivingly received on the first firingpulley3964 such that rotation of the firing drivengear3962 will drive the firingcable3884.
Also in various embodiments, thecable drive transmission3920 further includes abraking assembly3970. In at least one embodiment, for example, thebraking assembly3970 includes aclosure brake3972 that comprises aspring arm3973 that is attached to a portion of thetransmission housing3971. Theclosure brake3972 has agear lug3974 that is sized to engage the teeth of the closure drivengear3952 as will be discussed in further detail below. Thebraking assembly3970 further includes afiring brake3976 that comprises aspring arm3977 that is attached to another portion of thetransmission housing3971. Thefiring brake3976 has agear lug3978 that is sized to engage the teeth of the firing drivengear3962.
At least one embodiment of thesurgical tool3800 may be used as follows. Thetool mounting portion3900 is operably coupled to theinterface1240 of therobotic system1000. The controller or control unit of the robotic system is operated to locate the tissue to be cut and stapled between theopen anvil3824 and thestaple cartridge3834. When in that initial position, thebraking assembly3970 has locked the closure drivengear3952 and the firing drivengear3962 such that they cannot rotate. That is, as shown inFIG. 96, thegear lug3974 is in locking engagement with the closure drivengear3952 and thegear lug3978 is in locking engagement with the firing drivengear3962. Once thesurgical end effector3814 has been properly located, thecontroller1001 of therobotic system1000 will provide a control signal to the shifter motor3922 (or shifter solenoid) to move theshifter yoke3940 in the first direction. As theshifter yoke3940 is moved in the first direction, theclosure drive gear3950 moves thegear lug3974 out of engagement with the closure drivengear3952 as it moves into meshing engagement with the closure drivengear3952. As can be seen inFIG. 95, when in that position, thegear lug3978 remains in locking engagement with the firing drivengear3962 to prevent actuation of the firing system. Thereafter, therobotic controller1001 provides a first rotary actuation motion to the drivepulley3930 through the interface between the drivenelement1304 and the corresponding components of thetool holder1240. As thedrive pulley3930 is rotated in the first direction, theclosure cable3850 is rotated to drive thepreclamping collar3840 into closing engagement with thecam surface3825 of theanvil3824 to move it to the closed position thereby clamping the target tissue between theanvil3824 and thestaple cartridge3834. SeeFIG. 91. Once theanvil3824 has been moved to the closed position, therobotic controller1001 stops the application of the first rotary motion to the drivepulley3930. Thereafter, therobotic controller1001 may commence the firing process by sending another control signal to the shifter motor3922 (or shifter solenoid) to cause the shifter yoke to move in the second direction “SD” as shown inFIG. 97. As theshifter yoke3940 is moved in the second direction, the firingdrive gear3960 moves thegear lug3978 out of engagement with the firing drivengear3962 as it moves into meshing engagement with the firing drivengear3962. As can be seen inFIG. 97, when in that position, thegear lug3974 remains in locking engagement with the closure drivengear3952 to prevent actuation of the closure system. Thereafter, therobotic controller1001 is activated to provide the first rotary actuation motion to the drivepulley3930 through the interface between the drivenelement1304 and the corresponding components of thetool holder1240. As thedrive pulley3930 is rotated in the first direction, the firingcable3884 is rotated to drive thedynamic clamping member3860 in the distal direction “DD” thereby firing the stapes and cutting the tissue clamped in theend effector3814. Once therobotic system1000 determines that thedynamic clamping member3860 has reached its distal most position—either through sensors or through monitoring the amount of rotary input applied to the drivepulley3930, thecontroller1001 may then apply a second rotary motion to the drivepulley3930 to rotate theclosure cable3850 in an opposite direction to cause thedynamic clamping member3860 to be retracted in the proximal direction “PD”. Once the dynamic clamping member has been retracted to the starting position, the application of the second rotary motion to the drivepulley3930 is discontinued. Thereafter, the shifter motor3922 (or shifter solenoid) is powered to move theshifter yoke3940 to the closure position (FIG. 95). Once theclosure drive gear3950 is in meshing engagement with the closure drivengear3952, therobotic controller1001 may once again apply the second rotary motion to the drivepulley3930. Rotation of thedrive pulley3930 in the second direction causes theclosure cable3850 to retract thepreclamping collar3840 out of engagement with thecam surface3825 of theanvil3824 to permit theanvil3824 to move to an open position (by a spring or other means) to release the stapled tissue from thesurgical end effector3814.
FIG. 101 illustrates asurgical tool4000 that employs a gear drivenfiring bar4092 as shown inFIGS. 102-104. This embodiment includes anelongated shaft assembly4008 that extends from atool mounting portion4100. Thetool mounting portion4100 includes atool mounting plate4102 that operable supports a transmission arrangement4103 thereon. Theelongated shaft assembly4008 includes a rotatableproximal closure tube4010 that is rotatably journaled on aproximal spine member4020 that is rigidly coupled to thetool mounting plate4102. Theproximal spine member4020 has a distal end that is coupled to anelongated channel portion4022 of asurgical end effector4012. Thesurgical effector4012 may be substantially similar tosurgical end effector3412 described above. In addition, theanvil4024 of thesurgical end effector4012 may be opened and closed by adistal closure tube4030 that operably interfaces with theproximal closure tube4010.Distal closure tube4030 is identical todistal closure tube3430 described above. Similarly,proximal closure tube4010 is identical to proximalclosure tube segment3410 described above.
Anvil4024 is opened and closed by rotating theproximal closure tube4010 in manner described above with respect todistal closure tube3410. In at least one embodiment, the transmission arrangement comprises a closure transmission, generally designated as4011. As will be further discussed below, theclosure transmission4011 is configured to receive a corresponding first rotary motion from therobotic system1000 and convert that first rotary motion to a primary rotary motion for rotating the rotatableproximal closure tube4010 about the longitudinal tool axis LT-LT. As can be seen inFIG. 104, aproximal end4060 of theproximal closure tube4010 is rotatably supported within acradle arrangement4104 that is attached to atool mounting plate4102 of thetool mounting portion4100. Arotation gear4062 is formed on or attached to theproximal end4060 of theclosure tube segment4010 for meshing engagement with arotation drive assembly4070 that is operably supported on thetool mounting plate4102. In at least one embodiment, arotation drive gear4072 is coupled to a corresponding first one of the driven discs orelements1304 on the adapter side of thetool mounting plate4102 when thetool mounting portion4100 is coupled to thetool holder1270. SeeFIGS. 34 and 104. Therotation drive assembly4070 further comprises a rotary drivengear4074 that is rotatably supported on thetool mounting plate4102 in meshing engagement with therotation gear4062 and therotation drive gear4072. Application of a first rotary control motion from therobotic system1000 through thetool holder1270 and theadapter1240 to the corresponding drivenelement1304 will thereby cause rotation of therotation drive gear4072 by virtue of being operably coupled thereto. Rotation of therotation drive gear4072 ultimately results in the rotation of theclosure tube segment4010 to open and close theanvil4024 as described above.
As indicated above, theend effector4012 employs acutting element3860 as shown inFIGS. 102 and 103. In at least one non-limiting embodiment, the transmission arrangement4103 further comprises a knife drive transmission that includes aknife drive assembly4080.FIG. 104 illustrates one form ofknife drive assembly4080 for axially advancing theknife bar4092 that is attached to such cutting element using cables as described above with respect tosurgical tool3800. In particular, theknife bar4092 replaces the firingcable3884 employed in an embodiment ofsurgical tool3800. One form of theknife drive assembly4080 comprises arotary drive gear4082 that is coupled to a corresponding second one of the driven discs orelements1304 on the adapter side of thetool mounting plate4102 when thetool mounting portion4100 is coupled to thetool holder1270. SeeFIGS. 34 and 104. Theknife drive assembly4080 further comprises a first rotary drivengear assembly4084 that is rotatably supported on thetool mounting plate4102. The first rotary drivengear assembly4084 is in meshing engagement with a third rotary drivengear assembly4086 that is rotatably supported on thetool mounting plate4102 and which is in meshing engagement with a fourth rotary drivengear assembly4088 that is in meshing engagement with a threadedportion4094 ofdrive shaft assembly4090 that is coupled to theknife bar4092. Rotation of therotary drive gear4082 in a second rotary direction will result in the axial advancement of thedrive shaft assembly4090 andknife bar4092 in the distal direction “DD”. Conversely, rotation of therotary drive gear4082 in a secondary rotary direction (opposite to the second rotary direction) will cause thedrive shaft assembly4090 and theknife bar4092 to move in the proximal direction. Movement of thefiring bar4092 in the proximal direction “PD” will drive the cuttingelement3860 in the distal direction “DD”. Conversely, movement of thefiring bar4092 in the distal direction “DD” will result in the movement of thecutting element3860 in the proximal direction “PD”.
FIGS. 105-111 illustrate yet anothersurgical tool5000 that may be effectively employed in connection with arobotic system1000. In various forms, thesurgical tool5000 includes asurgical end effector5012 in the form of a surgical stapling instrument that includes anelongated channel5020 and a pivotally translatable clamping member, such as ananvil5070, which are maintained at a spacing that assures effective stapling and severing of tissue clamped in thesurgical end effector5012. As can be seen inFIG. 107, theelongated channel5020 may be substantially U-shaped in cross-section and be fabricated from, for example, titanium, 203 stainless steel, 304 stainless steel, 416 stainless steel, 17-4 stainless steel, 17-7 stainless steel, 6061 or 7075 aluminum, chromium steel, ceramic, etc. A substantially U-shapedmetal channel pan5022 may be supported in the bottom of theelongated channel5020 as shown.
Various embodiments include an actuation member in the form of asled assembly5030 that is operably supported within thesurgical end effector5012 and axially movable therein between a staring position and an ending position in response to control motions applied thereto. In some forms, themetal channel pan5022 has a centrally-disposedslot5024 therein to movably accommodate abase portion5032 of thesled assembly5030. Thebase portion5032 includes afoot portion5034 that is sized to be slidably received in aslot5021 in theelongated channel5020. SeeFIG. 107. As can be seen inFIGS. 107, 110, and 111, thebase portion5032 ofsled assembly5030 includes an axially extending threadedbore5036 that is configured to be threadedly received on a threadeddrive shaft5130 as will be discussed in further detail below. In addition, thesled assembly5030 includes anupstanding support portion5038 that supports a tissue cutting blade ortissue cutting instrument5040. Theupstanding support portion5038 terminates in atop portion5042 that has a pair of laterally extending retainingfins5044 protruding therefrom. As shown inFIG. 107, thefins5044 are positioned to be received within correspondingslots5072 inanvil5070. Thefins5044 and thefoot5034 serve to retain theanvil5070 in a desired spaced closed position as thesled assembly5030 is driven distally through the tissue clamped within the surgical end effector5014. As can also be seen inFIGS. 109 and 111, thesled assembly5030 further includes a reciprocatably or sequentiallyactivatable drive assembly5050 for driving staple pushers toward theclosed anvil5070.
More specifically and with reference toFIGS. 107 and 108, theelongated channel5020 is configured to operably support asurgical staple cartridge5080 therein. In at least one form, thesurgical staple cartridge5080 comprises abody portion5082 that may be fabricated from, for example, Vectra, Nylon (6/6 or 6/12) and include a centrally disposedslot5084 for accommodating theupstanding support portion5038 of thesled assembly5030. SeeFIG. 107. These materials could also be filled with glass, carbon, or mineral fill of 10%-40%. Thesurgical staple cartridge5080 further includes a plurality ofcavities5086 for movably supporting lines or rows of staple-supportingpushers5088 therein. Thecavities5086 may be arranged in spaced longitudinally extending lines orrows5090,5092,5094,5096. For example, therows5090 may be referred to herein as first outboard rows. Therows5092 may be referred to herein as first inboard rows. Therows5094 may be referred to as second inboard rows and therows5096 may be referred to as second outboard rows. The firstinboard row5090 and the firstoutboard row5092 are located on a first lateral side of thelongitudinal slot5084 and the secondinboard row5094 and the secondoutboard row5096 are located on a second lateral side of thelongitudinal slot5084. Thefirst staple pushers5088 in the firstinboard row5092 are staggered in relationship to thefirst staple pushers5088 in the firstoutboard row5090. Similarly, thesecond staple pushers5088 in the secondoutboard row5096 are staggered in relationship to thesecond pushers5088 in the secondinboard row5094. Eachpusher5088 operably supports asurgical staple5098 thereon.
In various embodiments, the sequentially-activatable or reciprocatably—activatable drive assembly5050 includes a pair ofoutboard drivers5052 and a pair ofinboard drivers5054 that are each attached to acommon shaft5056 that is rotatably mounted within thebase5032 of thesled assembly5030. Theoutboard drivers5052 are oriented to sequentially or reciprocatingly engage a corresponding plurality ofoutboard activation cavities5026 provided in thechannel pan5022. Likewise, theinboard drivers5054 are oriented to sequentially or reciprocatingly engage a corresponding plurality ofinboard activation cavities5028 provided in thechannel pan5022. Theinboard activation cavities5028 are arranged in a staggered relationship relative to the adjacentoutboard activation cavities5026. SeeFIG. 108. As can also be seen inFIGS. 108 and 110, in at least one embodiment, thesled assembly5030 further includesdistal wedge segments5060 andintermediate wedge segments5062 located on each side of thebore5036 to engage thepushers5088 as thesled assembly5030 is driven distally in the distal direction “DD”. As indicated above, thesled assembly5030 is threadedly received on a threadedportion5132 of adrive shaft5130 that is rotatably supported within theend effector5012. In various embodiments, for example, thedrive shaft5130 has adistal end5134 that is supported in adistal bearing5136 mounted in thesurgical end effector5012. SeeFIGS. 107 and 108.
In various embodiments, thesurgical end effector5012 is coupled to atool mounting portion5200 by anelongated shaft assembly5108. In at least one embodiment, thetool mounting portion5200 operably supports a transmission arrangement generally designated as5204 that is configured to receive rotary output motions from the robotic system. Theelongated shaft assembly5108 includes anouter closure tube5110 that is rotatable and axially movable on aspine member5120 that is rigidly coupled to a tool mounting plate5201 of thetool mounting portion5200. Thespine member5120 also has adistal end5122 that is coupled to theelongated channel portion5020 of thesurgical end effector5012.
In use, it may be desirable to rotate thesurgical end effector5012 about a longitudinal tool axis LT-LT defined by the elongated shaft assembly5008. In various embodiments, theouter closure tube5110 has aproximal end5112 that is rotatably supported on the tool mounting plate5201 of thetool drive portion5200 by a forward support cradle5203. Theproximal end5112 of theouter closure tube5110 is configured to operably interface with arotation transmission portion5206 of thetransmission arrangement5204. In various embodiments, theproximal end5112 of theouter closure tube5110 is also supported on aclosure sled5140 that is also movably supported on the tool mounting plate5201. A closuretube gear segment5114 is formed on theproximal end5112 of theouter closure tube5110 for meshing engagement with arotation drive assembly5150 of therotation transmission5206. As can be seen inFIG. 105, therotation drive assembly5150, in at least one embodiment, comprises arotation drive gear5152 that is coupled to a corresponding first one of the driven discs orelements1304 on theadapter side1307 of the tool mounting plate5201 when thetool drive portion5200 is coupled to thetool holder1270. Therotation drive assembly5150 further comprises a rotary drivengear5154 that is rotatably supported on the tool mounting plate5201 in meshing engagement with the closuretube gear segment5114 and therotation drive gear5152. Application of a first rotary control motion from therobotic system1000 through thetool holder1270 and theadapter1240 to the corresponding drivenelement1304 will thereby cause rotation of therotation drive gear5152. Rotation of therotation drive gear5152 ultimately results in the rotation of the elongated shaft assembly5108 (and the end effector5012) about the longitudinal tool axis LT-LT (represented by arrow “R” inFIG. 105).
Closure of theanvil5070 relative to thesurgical staple cartridge5080 is accomplished by axially moving theouter closure tube5110 in the distal direction “DD”. Such axial movement of theouter closure tube5110 may be accomplished by a closure transmission portionclosure transmission portion5144 of thetransmission arrangement5204. As indicated above, in various embodiments, theproximal end5112 of theouter closure tube5110 is supported by theclosure sled5140 which enables theproximal end5112 to rotate relative thereto, yet travel axially with theclosure sled5140. In particular, as can be seen inFIG. 105, theclosure sled5140 has anupstanding tab5141 that extends into aradial groove5115 in theproximal end portion5112 of theouter closure tube5110. In addition, as was described above, theclosure sled5140 is slidably mounted to the tool mounting plate5201. In various embodiments, theclosure sled5140 has anupstanding portion5142 that has aclosure rack gear5143 formed thereon. Theclosure rack gear5143 is configured for driving engagement with theclosure transmission5144.
In various forms, theclosure transmission5144 includes aclosure spur gear5145 that is coupled to a corresponding second one of the driven discs orelements1304 on theadapter side1307 of the tool mounting plate5201. Thus, application of a second rotary control motion from therobotic system1000 through thetool holder1270 and theadapter1240 to the corresponding second drivenelement1304 will cause rotation of theclosure spur gear5145 when theinterface1230 is coupled to thetool mounting portion5200. Theclosure transmission5144 further includes a driven closure gear set5146 that is supported in meshing engagement with theclosure spur gear5145 and theclosure rack gear5143. Thus, application of a second rotary control motion from therobotic system1000 through thetool holder1270 and theadapter1240 to the corresponding second drivenelement1304 will cause rotation of theclosure spur gear5145 and ultimately drive theclosure sled5140 and theouter closure tube5110 axially. The axial direction in which theclosure tube5110 moves ultimately depends upon the direction in which the second drivenelement1304 is rotated. For example, in response to one rotary closure motion received from therobotic system1000, theclosure sled5140 will be driven in the distal direction “DD” and ultimately theouter closure tube5110 will be driven in the distal direction as well. Theouter closure tube5110 has anopening5117 in the distal end5116 that is configured for engagement with a tab5071 on theanvil5070 in the manners described above. As theouter closure tube5110 is driven distally, the proximal end5116 of theclosure tube5110 will contact theanvil5070 and pivot it closed. Upon application of an “opening” rotary motion from therobotic system1000, theclosure sled5140 andouter closure tube5110 will be driven in the proximal direction “PD” and pivot theanvil5070 to the open position in the manners described above.
In at least one embodiment, thedrive shaft5130 has aproximal end5137 that has aproximal shaft gear5138 attached thereto. Theproximal shaft gear5138 is supported in meshing engagement with adistal drive gear5162 attached to arotary drive bar5160 that is rotatably supported withspine member5120. Rotation of therotary drive bar5160 and ultimatelyrotary drive shaft5130 is controlled by arotary knife transmission5207 which comprises a portion of thetransmission arrangement5204 supported on the tool mounting plate5210. In various embodiments, therotary knife transmission5207 comprises a rotaryknife drive system5170 that is operably supported on the tool mounting plate5201. In various embodiments, theknife drive system5170 includes arotary drive gear5172 that is coupled to a corresponding third one of the driven discs orelements1304 on the adapter side of the tool mounting plate5201 when thetool drive portion5200 is coupled to thetool holder1270. Theknife drive system5170 further comprises a first rotary drivengear5174 that is rotatably supported on the tool mounting plate5201 in meshing engagement with a second rotary drivengear5176 and therotary drive gear5172. The second rotary drivengear5176 is coupled to aproximal end portion5164 of therotary drive bar5160.
Rotation of therotary drive gear5172 in a first rotary direction will result in the rotation of therotary drive bar5160 androtary drive shaft5130 in a first direction. Conversely, rotation of therotary drive gear5172 in a second rotary direction (opposite to the first rotary direction) will cause therotary drive bar5160 androtary drive shaft5130 to rotate in a second direction.2400. Thus, rotation of thedrive shaft2440 results in rotation of thedrive sleeve2400.
One method of operating thesurgical tool5000 will now be described. Thetool drive5200 is operably coupled to theinterface1240 of therobotic system1000. Thecontroller1001 of therobotic system1000 is operated to locate the tissue to be cut and stapled between theopen anvil5070 and thesurgical staple cartridge5080. Once thesurgical end effector5012 has been positioned by therobot system1000 such that the target tissue is located between theanvil5070 and thesurgical staple cartridge5080, thecontroller1001 of therobotic system1000 may be activated to apply the second rotary output motion to the second drivenelement1304 coupled to theclosure spur gear5145 to drive theclosure sled5140 and theouter closure tube5110 axially in the distal direction to pivot theanvil5070 closed in the manner described above. Once therobotic controller1001 determines that theanvil5070 has been closed by, for example, sensors in thesurgical end effector5012 and/or thetool drive portion5200, therobotic controller1001 system may provide the surgeon with an indication that signifies the closure of the anvil. Such indication may be, for example, in the form of a light and/or audible sound, tactile feedback on the control members, etc. Then the surgeon may initiate the firing process. In alternative embodiments, however, therobotic controller1001 may automatically commence the firing process.
To commence the firing process, the robotic controller applies a third rotary output motion to the third driven disc orelement1304 coupled to therotary drive gear5172. Rotation of therotary drive gear5172 results in the rotation of therotary drive bar5160 androtary drive shaft5130 in the manner described above. Firing and formation of thesurgical staples5098 can be best understood from reference toFIGS. 106, 108, and109. As thesled assembly5030 is driven in the distal direction “DD” through thesurgical staple cartridge5080, thedistal wedge segments5060 first contact thestaple pushers5088 and start to move them toward theclosed anvil5070. As thesled assembly5030 continues to move distally, theoutboard drivers5052 will drop into the correspondingactivation cavity5026 in thechannel pan5022. The opposite end of eachoutboard driver5052 will then contact the correspondingoutboard pusher5088 that has moved up the distal andintermediate wedge segments5060,5062. Further distal movement of thesled assembly5030 causes theoutboard drivers5052 to rotate and drive the correspondingpushers5088 toward theanvil5070 to cause thestaples5098 supported thereon to be formed as they are driven into theanvil5070. It will be understood that as thesled assembly5030 moves distally, theknife blade5040 cuts through the tissue that is clamped between the anvil and the staple cartridge. Because theinboard drivers5054 andoutboard drivers5052 are attached to thesame shaft5056 and theinboard drivers5054 are radially offset from theoutboard drivers5052 on theshaft5056, as theoutboard drivers5052 are driving theircorresponding pushers5088 toward theanvil5070, theinboard drivers5054 drop into their nextcorresponding activation cavity5028 to cause them to rotatably or reciprocatingly drive the correspondinginboard pushers5088 towards theclosed anvil5070 in the same manner. Thus, the laterally correspondingoutboard staples5098 on each side of the centrally disposedslot5084 are simultaneously formed together and the laterally correspondinginboard staples5098 on each side of theslot5084 are simultaneously formed together as thesled assembly5030 is driven distally. Once therobotic controller1001 determines that thesled assembly5030 has reached its distal most position—either through sensors or through monitoring the amount of rotary input applied to thedrive shaft5130 and/or therotary drive bar5160, thecontroller1001 may then apply a third rotary output motion to thedrive shaft5130 to rotate thedrive shaft5130 in an opposite direction to retract thesled assembly5030 back to its starting position. Once thesled assembly5030 has been retracted to the starting position (as signaled by sensors in theend effector5012 and/or the tool drive portion5200), the application of the second rotary motion to thedrive shaft5130 is discontinued. Thereafter, the surgeon may manually activate the anvil opening process or it may be automatically commenced by therobotic controller1001. To open theanvil5070, the second rotary output motion is applied to theclosure spur gear5145 to drive theclosure sled5140 and theouter closure tube5110 axially in the proximal direction. As theclosure tube5110 moves proximally, theopening5117 in the distal end5116 of theclosure tube5110 contacts the tab5071 on theanvil5070 to pivot theanvil5070 to the open position. A spring may also be employed to bias theanvil5070 to the open position when the closure tube5116 has been returned to the starting position. Again, sensors in thesurgical end effector5012 and/or thetool mounting portion5200 may provide therobotic controller1001 with a signal indicating that theanvil5070 is now open. Thereafter, thesurgical end effector5012 may be withdrawn from the surgical site.
FIGS. 112-117 diagrammatically depict the sequential firing of staples in asurgical tool assembly5000′ that is substantially similar to thesurgical tool assembly5000 described above. In this embodiment, the inboard andoutboard drivers5052′,5054′ have a cam-like shape with acam surface5053 and anactuator protrusion5055 as shown inFIGS. 112-118. Thedrivers5052′,5054′ are journaled on thesame shaft5056′ that is rotatably supported by thesled assembly5030′. In this embodiment, thesled assembly5030′ hasdistal wedge segments5060′ for engaging thepushers5088.FIG. 112 illustrates an initial position of two inboard oroutboard drivers5052′,5054′ as thesled assembly5030′ is driven in the distal direction “DD”. As can be seen in that Figure, thepusher5088ahas advanced up thewedge segment5060′ and has contacted thedriver5052′,5054′. Further travel of thesled assembly5030′ in the distal direction causes thedriver5052′,5054′ to pivot in the “P” direction (FIG. 113) until theactuator portion5055 contacts theend wall5029aof theactivation cavity5026,5028 as shown inFIG. 114. Continued advancement of thesled assembly5030′ in the distal direction “DD” causes thedriver5052′,5054′ to rotate in the “D” direction as shown inFIG. 115. As thedriver5052′,5054′ rotates, thepusher5088arides up thecam surface5053 to the final vertical position shown inFIG. 116. When thepusher5088areaches the final vertical position shown inFIGS. 116 and 117, the staple (not shown) supported thereon has been driven into the staple forming surface of the anvil to form the staple.
FIGS. 119-124 illustrate asurgical end effector5312 that may be employed for example, in connection with thetool mounting portion1300 andshaft2008 described in detail above. In various forms, thesurgical end effector5312 includes anelongated channel5322 that is constructed as described above for supporting asurgical staple cartridge5330 therein. Thesurgical staple cartridge5330 comprises abody portion5332 that includes a centrally disposedslot5334 for accommodating anupstanding support portion5386 of asled assembly5380. SeeFIGS. 119-121. The surgical staplecartridge body portion5332 further includes a plurality ofcavities5336 for movably supporting staple-supportingpushers5350 therein. Thecavities5336 may be arranged in spaced longitudinally extendingrows5340,5342,5344,5346. Therows5340,5342 are located on one lateral side of thelongitudinal slot5334 and therows5344,5346 are located on the other side oflongitudinal slot5334. In at least one embodiment, thepushers5350 are configured to support twosurgical staples5352 thereon. In particular, eachpusher5350 located on one side of theelongated slot5334 supports onestaple5352 inrow5340 and onestaple5352 inrow5342 in a staggered orientation. Likewise, eachpusher5350 located on the other side of theelongated slot5334 supports onesurgical staple5352 inrow5344 and anothersurgical staple5352 inrow5346 in a staggered orientation. Thus, everypusher5350 supports twosurgical staples5352.
As can be further seen inFIGS. 119, 120, thesurgical staple cartridge5330 includes a plurality ofrotary drivers5360. More particularly, therotary drivers5360 on one side of theelongated slot5334 are arranged in asingle line5370 and correspond to thepushers5350 inlines5340,5342. In addition, therotary drivers5360 on the other side of theelongated slot5334 are arranged in asingle line5372 and correspond to thepushers5350 inlines5344,5346. As can be seen inFIG. 119, eachrotary driver5360 is rotatably supported within thestaple cartridge body5332. More particularly, eachrotary driver5360 is rotatably received on acorresponding driver shaft5362. Eachdriver5360 has anarcuate ramp portion5364 formed thereon that is configured to engage an arcuatelower surface5354 formed on eachpusher5350. SeeFIG. 124. In addition, eachdriver5360 has alower support portion5366 extend therefrom to slidably support thepusher5360 on thechannel5322. Eachdriver5360 has a downwardly extendingactuation rod5368 that is configured for engagement with asled assembly5380.
As can be seen inFIG. 121, in at least one embodiment, thesled assembly5380 includes abase portion5382 that has afoot portion5384 that is sized to be slidably received in aslot5333 in thechannel5322. SeeFIG. 119. Thesled assembly5380 includes anupstanding support portion5386 that supports a tissue cutting blade ortissue cutting instrument5388. Theupstanding support portion5386 terminates in atop portion5390 that has a pair of laterally extending retainingfins5392 protruding therefrom. Thefins5392 are positioned to be received within corresponding slots (not shown) in the anvil (not shown). As with the above-described embodiments, thefins5392 and thefoot portion5384 serve to retain the anvil (not shown) in a desired spaced closed position as thesled assembly5380 is driven distally through the tissue clamped within thesurgical end effector5312. Theupstanding support portion5386 is configured for attachment to a knife bar2200 (FIG. 40). Thesled assembly5380 further has a horizontally-extendingactuator plate5394 that is shaped for actuating engagement with each of theactuation rods5368 on thepushers5360.
Operation of thesurgical end effector5312 will now be explained with reference toFIGS. 119 and 120. As thesled assembly5380 is driven in the distal direction “DD” through thestaple cartridge5330, theactuator plate5394 sequentially contacts theactuation rods5368 on thepushers5360. As thesled assembly5380 continues to move distally, theactuator plate5394 sequentially contacts theactuator rods5368 of thedrivers5360 on each side of theelongated slot5334. Such action causes thedrivers5360 to rotate from a first unactuated position to an actuated portion wherein thepushers5350 are driven towards the closed anvil. As thepushers5350 are driven toward the anvil, thesurgical staples5352 thereon are driven into forming contact with the underside of the anvil. Once therobotic system1000 determines that thesled assembly5080 has reached its distal most position through sensors or other means, the control system of therobotic system1000 may then retract the knife bar andsled assembly5380 back to the starting position. Thereafter, the robotic control system may then activate the procedure for returning the anvil to the open position to release the stapled tissue.
FIGS. 125-129 depict one form of an automated reloading system embodiment of the present invention, generally designated as5500. In one form, theautomated reloading system5500 is configured to replace a “spent” surgical end effector component in a manipulatable surgical tool portion of a robotic surgical system with a “new” surgical end effector component. As used herein, the term “surgical end effector component” may comprise, for example, a surgical staple cartridge, a disposable loading unit or other end effector components that, when used, are spent and must be replaced with a new component. Furthermore, the term “spent” means that the end effector component has been activated and is no longer useable for its intended purpose in its present state. For example, in the context of a surgical staple cartridge or disposable loading unit, the term “spent” means that at least some of the unformed staples that were previously supported therein have been “fired” therefrom. As used herein, the term “new” surgical end effector component refers to an end effector component that is in condition for its intended use. In the context of a surgical staple cartridge or disposable loading unit, for example, the term “new” refers to such a component that has unformed staples therein and which is otherwise ready for use.
In various embodiments, theautomated reloading system5500 includes abase portion5502 that may be strategically located within awork envelope1109 of a robotic arm cart1100 (FIG. 26) of arobotic system1000. As used herein, the term “manipulatable surgical tool portion” collectively refers to a surgical tool of the various types disclosed herein and other forms of surgical robotically-actuated tools that are operably attached to, for example, arobotic arm cart1100 or similar device that is configured to automatically manipulate and actuate the surgical tool. The term “work envelope” as used herein refers to the range of movement of the manipulatable surgical tool portion of the robotic system.FIG. 26 generally depicts an area that may comprise a work envelope of therobotic arm cart1100. Those of ordinary skill in the art will understand that the shape and size of the work envelope depicted therein is merely illustrative. The ultimate size, shape and location of a work envelope will ultimately depend upon the construction, range of travel limitations, and location of the manipulatable surgical tool portion. Thus, the term “work envelope” as used herein is intended to cover a variety of different sizes and shapes of work envelopes and should not be limited to the specific size and shape of the sample work envelope depicted inFIG. 26.
As can be seen inFIG. 125, thebase portion5502 includes a new component support section orarrangement5510 that is configured to operably support at least one new surgical end effector component in a “loading orientation”. As used herein, the term “loading orientation” means that the new end effector component is supported in such away so as to permit the corresponding component support portion of the manipulatable surgical tool portion to be brought into loading engagement with (i.e., operably seated or operably attached to) the new end effector component (or the new end effector component to be brought into loading engagement with the corresponding component support portion of the manipulatable surgical tool portion) without human intervention beyond that which may be necessary to actuate the robotic system. As will be further appreciated as the present Detailed Description proceeds, in at least one embodiment, the preparation nurse will load the new component support section before the surgery with the appropriate length and color cartridges (some surgical staple cartridges may support certain sizes of staples the size of which may be indicated by the color of the cartridge body) required for completing the surgical procedure. However, no direct human interaction is necessary during the surgery to reload the robotic endocutter. In one form, the surgical end effector component comprises astaple cartridge2034 that is configured to be operably seated within a component support portion (elongated channel) of any of the various other end effector arrangements described above. For explanation purposes, new (unused) cartridges will be designated as “2034a” and spent cartridges will be designated as “2034b”. The Figures depictcartridges2034a,2034bdesigned for use with asurgical end effector2012 that includes achannel2022 and ananvil2024, the construction and operation of which were discussed in detail above.Cartridges2034a,2034bare identical tocartridges2034 described above. In various embodiments, thecartridges2034a,2034bare configured to be snappingly retained (i.e., loading engagement) within thechannel2022 of asurgical end effector2012. As the present Detailed Description proceeds, however, those of ordinary skill in the art will appreciate that the unique and novel features of the automatedcartridge reloading system5500 may be effectively employed in connection with the automated removal and installation of other cartridge arrangements without departing from the spirit and scope of the present invention.
In the depicted embodiment, the term “loading orientation” means that thedistal tip portion2035aof the a newsurgical staple cartridge2034ais inserted into acorresponding support cavity5512 in the newcartridge support section5510 such that theproximal end portion2037aof the newsurgical staple cartridge2034ais located in a convenient orientation for enabling thearm cart1100 to manipulate thesurgical end effector2012 into a position wherein thenew cartridge2034amay be automatically loaded into thechannel2022 of thesurgical end effector2012. In various embodiments, thebase5502 includes at least onesensor5504 which communicates with thecontrol system1003 of therobotic controller1001 to provide thecontrol system1003 with the location of thebase5502 and/or the reload length and color doe each staged ornew cartridge2034a.
As can also be seen in the Figures, thebase5502 further includes acollection receptacle5520 that is configured to collect spentcartridges2034bthat have been removed or disengaged from thesurgical end effector2012 that is operably attached to therobotic system1000. In addition, in one form, theautomated reloading system5500 includes anextraction system5530 for automatically removing the spent end effector component from the corresponding support portion of the end effector or manipulatable surgical tool portion without specific human intervention beyond that which may be necessary to activate the robotic system. In various embodiments, theextraction system5530 includes anextraction hook member5532. In one form, for example, theextraction hook member5532 is rigidly supported on thebase portion5502. In one embodiment, the extraction hook member has at least onehook5534 formed thereon that is configured to hookingly engage thedistal end2035 of a spentcartridge2034bwhen it is supported in theelongated channel2022 of thesurgical end effector2012. In various forms, theextraction hook member5532 is conveniently located within a portion of thecollection receptacle5520 such that when the spent end effector component (cartridge2034b) is brought into extractive engagement with theextraction hook member5532, the spent end effector component (cartridge2034b) is dislodged from the corresponding component support portion (elongated channel2022), and falls into thecollection receptacle5020. Thus, to use this embodiment, the manipulatable surgical tool portion manipulates the end effector attached thereto to bring thedistal end2035 of the spentcartridge2034btherein into hooking engagement with thehook5534 and then moves the end effector in such a way to dislodge the spentcartridge2034bfrom theelongated channel2022.
In other arrangements, theextraction hook member5532 comprises a rotatable wheel configuration that has a pair of diametrically-opposedhooks5334 protruding therefrom. SeeFIGS. 125 and 128. Theextraction hook member5532 is rotatably supported within thecollection receptacle5520 and is coupled to anextraction motor5540 that is controlled by thecontroller1001 of the robotic system. This form of theautomated reloading system5500 may be used as follows.FIG. 127 illustrates the introduction of thesurgical end effector2012 that is operably attached to the manipulatablesurgical tool portion1200. As can be seen in that Figure, thearm cart1100 of therobotic system1000 locates thesurgical end effector2012 in the shown position wherein thehook end5534 of theextraction member5532 hookingly engages thedistal end2035 of the spentcartridge2034bin thesurgical end effector2012. Theanvil2024 of thesurgical end effector2012 is in the open position. After thedistal end2035 of the spentcartridge2034bis engaged with thehook end5532, theextraction motor5540 is actuated to rotate theextraction wheel5532 to disengage the spentcartridge2034bfrom thechannel2022. To assist with the disengagement of the spentcartridge2034bfrom the channel2022 (or if theextraction member5530 is stationary), therobotic system1000 may move thesurgical end effector2012 in an upward direction (arrow “U” inFIG. 128). As the spentcartridge2034bis dislodged from thechannel2022, the spentcartridge2034bfalls into thecollection receptacle5520. Once the spentcartridge2034bhas been removed from thesurgical end effector2012, therobotic system1000 moves thesurgical end effector2012 to the position shown inFIG. 126.
In various embodiments, a sensor arrangement5533 is located adjacent to theextraction member5532 that is in communication with thecontroller1001 of therobotic system1000. The sensor arrangement5533 may comprise a sensor that is configured to sense the presence of thesurgical end effector2012 and, more particularly the tip2035bof the spentsurgical staple cartridge2034bthereof as the distal tip portion2035bis brought into engagement with theextraction member5532. In some embodiments, the sensor arrangement5533 may comprise, for example, a light curtain arrangement. However, other forms of proximity sensors may be employed. In such arrangement, when thesurgical end effector2012 with the spentsurgical staple cartridge2034bis brought into extractive engagement with theextraction member5532, the sensor senses the distal tip2035bof thesurgical staple cartridge2034b(e.g., the light curtain is broken). When theextraction member5532 spins and pops thesurgical staple cartridge2034bloose and it falls into thecollection receptacle5520, the light curtain is again unbroken. Because thesurgical end effector2012 was not moved during this procedure, therobotic controller1001 is assured that the spentsurgical staple cartridge2034bhas been removed therefrom. Other sensor arrangements may also be successfully employed to provide therobotic controller1001 with an indication that the spentsurgical staple cartridge2034bhas been removed from thesurgical end effector2012.
As can be seen inFIG. 129, thesurgical end effector2012 is positioned to grasp a newsurgical staple cartridge2034abetween thechannel2022 and theanvil2024. More specifically, as shown inFIGS. 126 and 129, eachcavity5512 has a correspondingupstanding pressure pad5514 associated with it. Thesurgical end effector2012 is located such that thepressure pad5514 is located between thenew cartridge2034aand theanvil2024. Once in that position, therobotic system1000 closes theanvil2024 onto thepressure pad5514 which serves to push thenew cartridge2034ainto snapping engagement with thechannel2022 of thesurgical end effector2012. Once thenew cartridge2034ahas been snapped into position within theelongated channel2022, therobotic system1000 then withdraws thesurgical end effector2012 from the automatedcartridge reloading system5500 for use in connection with performing another surgical procedure.
FIGS. 130-134 depict anotherautomated reloading system5600 that may be used to remove a spentdisposable loading unit3612 from a manipulatable surgical tool arrangement3600 (FIGS. 77-90) that is operably attached to anarm cart1100 or other portion of arobotic system1000 and reload a newdisposable loading unit3612 therein. As can be seen inFIGS. 130 and 131, one form of theautomated reloading system5600 includes ahousing5610 that has a movable support assembly in the form of a rotary carrouseltop plate5620 supported thereon which cooperates with thehousing5610 to form a hollowenclosed area5612. Theautomated reloading system5600 is configured to be operably supported within the work envelop of the manipulatable surgical tool portion of a robotic system as was described above. In various embodiments, therotary carrousel plate5620 has a plurality ofholes5622 for supporting a plurality oforientation tubes5660 therein. As can be seen inFIGS. 131 and 132, therotary carrousel plate5620 is affixed to aspindle shaft5624. Thespindle shaft5624 is centrally disposed within theenclosed area5612 and has aspindle gear5626 attached thereto. Thespindle gear5626 is in meshing engagement with acarrousel drive gear5628 that is coupled to acarrousel drive motor5630 that is in operative communication with therobotic controller1001 of therobotic system1000.
Various embodiments of theautomated reloading system5600 may also include a carrousel locking assembly, generally designated as5640. In various forms, thecarrousel locking assembly5640 includes acam disc5642 that is affixed to thespindle shaft5624. Thespindle gear5626 may be attached to the underside of thecam disc5642 and thecam disc5642 may be keyed onto thespindle shaft5624. In alternative arrangements, thespindle gear5626 and thecam disc5642 may be independently non-rotatably affixed to thespindle shaft5624. As can be seen inFIGS. 131 and 132, a plurality ofnotches5644 are spaced around the perimeter of thecam disc5642. Alocking arm5648 is pivotally mounted within thehousing5610 and is biased into engagement with the perimeter of thecam disc5642 by alocking spring5649. As can be seen inFIG. 130, the outer perimeter of thecam disc5642 is rounded to facilitate rotation of thecam disc5642 relative to thelocking arm5648. The edges of eachnotch5644 are also rounded such that when thecam disc5642 is rotated, thelocking arm5648 is cammed out of engagement with thenotches5644 by the perimeter of thecam disc5642.
Various forms of theautomated reloading system5600 are configured to support a portable/replaceable tray assembly5650 that is configured to support a plurality ofdisposable loading units3612 inindividual orientation tubes5660. More specifically and with reference toFIGS. 131 and 132, thereplaceable tray assembly5650 comprises atray5652 that has a centrally-disposedlocator spindle5654 protruding from the underside thereof. Thelocator spindle5654 is sized to be received within ahollow end5625 ofspindle shaft5624. Thetray5652 has a plurality ofholes5656 therein that are configured to support anorientation tube5660 therein. Eachorientation tube5660 is oriented within a correspondinghole5656 in thereplaceable tray assembly5650 in a desired orientation by a locatingfin5666 on theorientation tube5660 that is designed to be received within acorresponding locating slot5658 in thetray assembly5650. In at least one embodiment, the locatingfin5666 has a substantially V-shaped cross-sectional shape that is sized to fit within a V-shapedlocating slot5658. Such arrangement serves to orient theorientation tube5660 in a desired starting position while enabling it to rotate within thehole5656 when a rotary motion is applied thereto. That is, when a rotary motion is applied to theorientation tube5660 the V-shapedlocating fin5666 will pop out of its corresponding locating slot enabling thetube5660 to rotate relative to thetray5652 as will be discussed in further detail below. As can also be seen inFIGS. 130-132, thereplaceable tray5652 may be provided with one ormore handle portions5653 to facilitate transport of thetray assembly5652 when loaded withorientation tubes5660.
As can be seen inFIG. 134, eachorientation tube5660 comprises abody portion5662 that has a flangedopen end5664. Thebody portion5662 defines acavity5668 that is sized to receive a portion of adisposable loading unit3612 therein. To properly orient thedisposable loading unit3612 within theorientation tube5660, thecavity5668 has aflat locating surface5670 formed therein. As can be seen inFIG. 134, theflat locating surface5670 is configured to facilitate the insertion of the disposable loading unit into thecavity5668 in a desired or predetermined non-rotatable orientation. In addition, theend5669 of thecavity5668 may include a foam orcushion material5672 that is designed to cushion the distal end of thedisposable loading unit3612 within thecavity5668. Also, the length of the locating surface may cooperate with a slidingsupport member3689 of theaxial drive assembly3680 of thedisposable loading unit3612 to further locate thedisposable loading unit3612 at a desired position within theorientation tube5660.
Theorientation tubes5660 may be fabricated from Nylon, polycarbonate, polyethylene, liquid crystal polymer, 6061 or 7075 aluminum, titanium, 300 or 400 series stainless steel, coated or painted steel, plated steel, etc. and, when loaded in thereplaceable tray5662 and thelocator spindle5654 is inserted into thehollow end5625 ofspindle shaft5624, theorientation tubes5660 extend throughcorresponding holes5662 in the carrouseltop plate5620. Eachreplaceable tray5662 is equipped with a location sensor5663 that communicates with thecontrol system1003 of thecontroller1001 of therobotic system1000. The sensor5663 serves to identify the location of the reload system, and the number, length, color and fired status of each reload housed in the tray. In addition, an optical sensor or sensors5665 that communicate with therobotic controller1001 may be employed to sense the type/size/length of disposable loading units that are loaded within thetray5662.
Various embodiments of theautomated reloading system5600 further include adrive assembly5680 for applying a rotary motion to theorientation tube5660 holding thedisposable loading unit3612 to be attached to theshaft3700 of the surgical tool3600 (collectively the “manipulatable surgical tool portion”) that is operably coupled to the robotic system. Thedrive assembly5680 includes asupport yoke5682 that is attached to thelocking arm5648. Thus, thesupport yoke5682 pivots with thelocking arm5648. Thesupport yoke5682 rotatably supports a tube idler wheel5684 and a tube drive wheel5686 that is driven by a tube motor5688 attached thereto. Tube motor5688 communicates with thecontrol system1003 and is controlled thereby. The tube idler wheel5684 and tube drive wheel5686 are fabricated from, for example, natural rubber, sanoprene, isoplast, etc. such that the outer surfaces thereof create sufficient amount of friction to result in the rotation of anorientation tube5660 in contact therewith upon activation of the tube motor5688. The idler wheel5684 and tube drive wheel5686 are oriented relative to each other to create a cradle area5687 therebetween for receiving anorientation tube5060 in driving engagement therein.
In use, one or more of theorientation tubes5660 loaded in theautomated reloading system5600 are left empty, while theother orientation tubes5660 may operably support a corresponding newdisposable loading unit3612 therein. As will be discussed in further detail below, theempty orientation tubes5660 are employed to receive a spentdisposable loading unit3612 therein.
Theautomated reloading system5600 may be employed as follows after thesystem5600 is located within the work envelope of the manipulatable surgical tool portion of a robotic system. If the manipulatable surgical tool portion has a spentdisposable loading unit3612 operably coupled thereto, one of theorientation tubes5660 that are supported on thereplaceable tray5662 is left empty to receive the spentdisposable loading unit3612 therein. If, however, the manipulatable surgical tool portion does not have adisposable loading unit3612 operably coupled thereto, each of theorientation tubes5660 may be provided with a properly oriented newdisposable loading unit3612.
As described hereinabove, thedisposable loading unit3612 employs a rotary “bayonet-type” coupling arrangement for operably coupling thedisposable loading unit3612 to a corresponding portion of the manipulatable surgical tool portion. That is, to attach adisposable loading unit3612 to the corresponding portion of the manipulatable surgical tool portion (3700—seeFIGS. 83, 84), a rotary installation motion must be applied to thedisposable loading unit3612 and/or the corresponding portion of the manipulatable surgical tool portion when those components have been moved into loading engagement with each other. Such installation motions are collectively referred to herein as “loading motions”. Likewise, to decouple a spentdisposable loading unit3612 from the corresponding portion of the manipulatable surgical tool, a rotary decoupling motion must be applied to the spentdisposable loading unit3612 and/or the corresponding portion of the manipulatable surgical tool portion while simultaneously moving the spent disposable loading unit and the corresponding portion of the manipulatable surgical tool away from each other. Such decoupling motions are collectively referred to herein as “extraction motions”.
To commence the loading process, therobotic system1000 is activated to manipulate the manipulatable surgical tool portion and/or theautomated reloading system5600 to bring the manipulatable surgical tool portion into loading engagement with the newdisposable loading unit3612 that is supported in theorientation tube5660 that is in driving engagement with thedrive assembly5680. Once the robotic controller1001 (FIG. 25) of therobotic control system1000 has located the manipulatable surgical tool portion in loading engagement with the newdisposable loading unit3612, therobotic controller1001 activates thedrive assembly5680 to apply a rotary loading motion to theorientation tube5660 in which the newdisposable loading unit3612 is supported and/or applies another rotary loading motion to the corresponding portion of the manipulatable surgical tool portion. Upon application of such rotary loading motions(s), therobotic controller1001 also causes the corresponding portion of the manipulatable surgical tool portion to be moved towards the newdisposable loading unit3612 into loading engagement therewith. Once thedisposable loading unit3612 is in loading engagement with the corresponding portion of the manipulatable tool portion, the loading motions are discontinued and the manipulatable surgical tool portion may be moved away from theautomated reloading system5600 carrying with it the newdisposable loading unit3612 that has been operably coupled thereto.
To decouple a spentdisposable loading unit3612 from a corresponding manipulatable surgical tool portion, therobotic controller1001 of the robotic system manipulates the manipulatable surgical tool portion so as to insert the distal end of the spentdisposable loading unit3612 into theempty orientation tube5660 that remains in driving engagement with thedrive assembly5680. Thereafter, therobotic controller1001 activates thedrive assembly5680 to apply a rotary extraction motion to theorientation tube5660 in which the spentdisposable loading unit3612 is supported and/or applies a rotary extraction motion to the corresponding portion of the manipulatable surgical tool portion. Therobotic controller1001 also causes the manipulatable surgical tool portion to withdraw away from the spent rotarydisposable loading unit3612. Thereafter the rotary extraction motion(s) are discontinued.
After the spentdisposable loading unit3612 has been removed from the manipulatable surgical tool portion, therobotic controller1001 may activate thecarrousel drive motor5630 to index the carrouseltop plate5620 to bring anotherorientation tube5660 that supports a newdisposable loading unit3612 therein into driving engagement with thedrive assembly5680. Thereafter, the loading process may be repeated to attach the newdisposable loading unit3612 therein to the portion of the manipulatable surgical tool portion. Therobotic controller1001 may record the number of disposable loading units that have been used from a particularreplaceable tray5652. Once thecontroller1001 determines that all of the newdisposable loading units3612 have been used from that tray, thecontroller1001 may provide the surgeon with a signal (visual and/or audible) indicating that thetray5652 supporting all of the spentdisposable loading units3612 must be replaced with anew tray5652 containing newdisposable loading units3612.
FIGS. 135-140 depict another non-limiting embodiment of asurgical tool6000 of the present invention that is well-adapted for use with arobotic system1000 that has a tool drive assembly1010 (FIG. 27) that is operatively coupled to amaster controller1001 that is operable by inputs from an operator (i.e., a surgeon). As can be seen inFIG. 135, thesurgical tool6000 includes asurgical end effector6012 that comprises an endocutter. In at least one form, thesurgical tool6000 generally includes anelongated shaft assembly6008 that has aproximal closure tube6040 and adistal closure tube6042 that are coupled together by an articulation joint6100. Thesurgical tool6000 is operably coupled to the manipulator by a tool mounting portion, generally designated as6200. Thesurgical tool6000 further includes aninterface6030 which may mechanically and electrically couple thetool mounting portion6200 to the manipulator in the various manners described in detail above.
In at least one embodiment, thesurgical tool6000 includes asurgical end effector6012 that comprises, among other things, at least onecomponent6024 that is selectively movable between first and second positions relative to at least oneother component6022 in response to various control motions applied tocomponent6024 as will be discussed in further detail below to perform a surgical procedure. In various embodiments,component6022 comprises anelongated channel6022 configured to operably support asurgical staple cartridge6034 therein andcomponent6024 comprises a pivotally translatable clamping member, such as ananvil6024. Various embodiments of thesurgical end effector6012 are configured to maintain theanvil6024 andelongated channel6022 at a spacing that assures effective stapling and severing of tissue clamped in thesurgical end effector6012. Unless otherwise stated, theend effector6012 is similar to thesurgical end effector2012 described above and includes a cutting instrument (not shown) and a sled (not shown). Theanvil6024 may include atab6027 at its proximal end that interacts with a component of the mechanical closure system (described further below) to facilitate the opening of theanvil6024. Theelongated channel6022 and theanvil6024 may be made of an electrically conductive material (such as metal) so that they may serve as part of an antenna that communicates with sensor(s) in the end effector, as described above. Thesurgical staple cartridge6034 could be made of a nonconductive material (such as plastic) and the sensor may be connected to or disposed in thesurgical staple cartridge6034, as was also described above.
As can be seen inFIG. 135, thesurgical end effector6012 is attached to thetool mounting portion6200 by theelongated shaft assembly6008 according to various embodiments. As shown in the illustrated embodiment, theelongated shaft assembly6008 includes an articulation joint generally designated as6100 that enables thesurgical end effector6012 to be selectively articulated about a first tool articulation axis AA1-AA1 that is substantially transverse to a longitudinal tool axis LT-LT and a second tool articulation axis AA2-AA2 that is substantially transverse to the longitudinal tool axis LT-LT as well as the first articulation axis AA1-AA1. SeeFIG. 136. In various embodiments, theelongated shaft assembly6008 includes aclosure tube assembly6009 that comprises aproximal closure tube6040 and adistal closure tube6042 that are pivotably linked by a pivot links6044 and6046. Theclosure tube assembly6009 is movably supported on a spine assembly generally designated as6102.
As can be seen inFIG. 137, theproximal closure tube6040 is pivotally linked to an intermediate closure tube joint6043 by anupper pivot link6044U and alower pivot link6044L such that the intermediate closure tube joint6043 is pivotable relative to theproximal closure tube6040 about a first closure axis CA1-CA1 and a second closure axis CA2-CA2. In various embodiments, the first closure axis CA1-CA1 is substantially parallel to the second closure axis CA2-CA2 and both closure axes CA1-CA1, CA2-CA2 are substantially transverse to the longitudinal tool axis LT-LT. As can be further seen inFIG. 134, the intermediate closure tube joint6043 is pivotally linked to thedistal closure tube6042 by aleft pivot link6046L and aright pivot link6046R such that the intermediate closure tube joint6043 is pivotable relative to thedistal closure tube6042 about a third closure axis CA3-CA3 and a fourth closure axis CA4-CA4. In various embodiments, the third closure axis CA3-CA3 is substantially parallel to the fourth closure axis CA4-CA4 and both closure axes CA3-CA3, CA4-CA4 are substantially transverse to the first and second closure axes CA1-CA1, CA2-CA2 as well as to longitudinal tool axis LT-LT.
Theclosure tube assembly6009 is configured to axially slide on thespine assembly6102 in response to actuation motions applied thereto. Thedistal closure tube6042 includes anopening6045 which interfaces with thetab6027 on theanvil6024 to facilitate opening of theanvil6024 as thedistal closure tube6042 is moved axially in the proximal direction “PD”. Theclosure tubes6040,6042 may be made of electrically conductive material (such as metal) so that they may serve as part of the antenna, as described above. Components of thespine assembly6102 may be made of a nonconductive material (such as plastic).
As indicated above, thesurgical tool6000 includes atool mounting portion6200 that is configured for operable attachment to thetool mounting assembly1010 of therobotic system1000 in the various manners described in detail above. As can be seen inFIG. 139, thetool mounting portion6200 comprises atool mounting plate6202 that operably supports a transmission arrangement6204 thereon. In various embodiments, the transmission arrangement6204 includes anarticulation transmission6142 that comprises a portion of anarticulation system6140 for articulating thesurgical end effector6012 about a first tool articulation axis TA1-TA1 and a second tool articulation axis TA2-TA2. The first tool articulation axis TA1-TA1 is substantially transverse to the second tool articulation axis TA2-TA2 and both of the first and second tool articulation axes are substantially transverse to the longitudinal tool axis LT-LT. SeeFIG. 136.
To facilitate selective articulation of thesurgical end effector6012 about the first and second tool articulation axes TA1-TA1, TA2-TA2, thespine assembly6102 comprises aproximal spine portion6110 that is pivotally coupled to adistal spine portion6120 bypivot pins6122 for selective pivotal travel about TA1-TA1. Similarly, thedistal spine portion6120 is pivotally attached to theelongated channel6022 of thesurgical end effector6012 bypivot pins6124 to enable thesurgical end effector6012 to selectively pivot about the second tool axis TA2-TA2 relative to thedistal spine portion6120.
In various embodiments, thearticulation system6140 further includes a plurality of articulation elements that operably interface with thesurgical end effector6012 and anarticulation control arrangement6160 that is operably supported in thetool mounting member6200 as will described in further detail below. In at least one embodiment, the articulation elements comprise a first pair offirst articulation cables6144 and6146. The first articulation cables are located on a first or right side of the longitudinal tool axis. Thus, the first articulation cables are referred to herein as a rightupper cable6144 and a rightlower cable6146. The rightupper cable6144 and the rightlower cable6146 extend throughcorresponding passages6147,6148, respectively along the right side of theproximal spine portion6110. SeeFIG. 140. Thearticulation system6140 further includes a second pair ofsecond articulation cables6150,6152. The second articulation cables are located on a second or left side of the longitudinal tool axis. Thus, the second articulation cables are referred to herein as a leftupper articulation cable6150 and aleft articulation cable6152. The leftupper articulation cable6150 and the leftlower articulation cable6152 extend throughpassages6153,6154, respectively in theproximal spine portion6110.
As can be seen inFIG. 136, the rightupper cable6144 extends around an upper pivot joint6123 and is attached to a left upper side of theelongated channel6022 at a left pivot joint6125. The rightlower cable6146 extends around a lower pivot joint6126 and is attached to a left lower side of theelongated channel6022 at left pivot joint6125. The leftupper cable6150 extends around the upper pivot joint6123 and is attached to a right upper side of theelongated channel6022 at a right pivot joint6127. The leftlower cable6152 extends around the lower pivot joint6126 and is attached to a right lower side of theelongated channel6022 at right pivot joint6127. Thus, to pivot thesurgical end effector6012 about the first tool articulation axis TA1-TA1 to the left (arrow “L”), the rightupper cable6144 and the rightlower cable6146 must be pulled in the proximal direction “PD”. To articulate thesurgical end effector6012 to the right (arrow “R”) about the first tool articulation axis TA1-TA1, the leftupper cable6150 and the leftlower cable6152 must be pulled in the proximal direction “PD”. To articulate thesurgical end effector6012 about the second tool articulation axis TA2-TA2, in an upward direction (arrow “U”), the rightupper cable6144 and the leftupper cable6150 must be pulled in the proximal direction “PD”. To articulate thesurgical end effector6012 in the downward direction (arrow “DW”) about the second tool articulation axis TA2-TA2, the rightlower cable6146 and the leftlower cable6152 must be pulled in the proximal direction “PD”.
The proximal ends of thearticulation cables6144,6146,6150,6152 are coupled to thearticulation control arrangement6160 which comprises a ball joint assembly that is a part of thearticulation transmission6142. More specifically and with reference toFIG. 140, the balljoint assembly6160 includes a ball-shapedmember6162 that is formed on a proximal portion of theproximal spine6110. Movably supported on the ball-shapedmember6162 is anarticulation control ring6164. As can be further seen inFIG. 140, the proximal ends of thearticulation cables6144,6146,6150,6152 are coupled to thearticulation control ring6164 by corresponding balljoint arrangements6166. Thearticulation control ring6164 is controlled by anarticulation drive assembly6170. As can be most particularly seen inFIG. 140, the proximal ends of thefirst articulation cables6144,6146 are attached to thearticulation control ring6164 at corresponding spacedfirst points6149,6151 that are located onplane6159. Likewise, the proximal ends of thesecond articulation cables6150,6152 are attached to thearticulation control ring6164 at corresponding spacedsecond points6153,6155 that are also located alongplane6159. As the present Detailed Description proceeds, those of ordinary skill in the art will appreciate that such cable attachment configuration on thearticulation control ring6164 facilitates the desired range of articulation motions as thearticulation control ring6164 is manipulated by thearticulation drive assembly6170.
In various forms, thearticulation drive assembly6170 comprises a horizontal articulation assembly generally designated as6171. In at least one form, the horizontal articulation assembly6171 comprises ahorizontal push cable6172 that is attached to ahorizontal gear arrangement6180. Thearticulation drive assembly6170 further comprises a vertically articulation assembly generally designated as6173. In at least one form, the vertical articulation assembly6173 comprises avertical push cable6174 that is attached to avertical gear arrangement6190. As can be seen inFIGS. 139 and 140, thehorizontal push cable6172 extends through asupport plate6167 that is attached to theproximal spine portion6110. The distal end of thehorizontal push cable6174 is attached to thearticulation control ring6164 by a corresponding ball/pivot joint6168. Thevertical push cable6174 extends through thesupport plate6167 and the distal end thereof is attached to thearticulation control ring6164 by a corresponding ball/pivot joint6169.
Thehorizontal gear arrangement6180 includes a horizontal drivengear6182 that is pivotally mounted on ahorizontal shaft6181 that is attached to a proximal portion of theproximal spine portion6110. The proximal end of thehorizontal push cable6172 is pivotally attached to the horizontal drivengear6182 such that, as the horizontal drivengear6172 is rotated about horizontal pivot axis HA, thehorizontal push cable6172 applies a first pivot motion to thearticulation control ring6164. Likewise, thevertical gear arrangement6190 includes a vertical drivengear6192 that is pivotally supported on a vertical shaft6191 attached to the proximal portion of theproximal spine portion6110 for pivotal travel about a vertical pivot axis VA. The proximal end of thevertical push cable6174 is pivotally attached to the vertical drivengear6192 such that as the vertical drivengear6192 is rotated about vertical pivot axis VA, thevertical push cable6174 applies a second pivot motion to thearticulation control ring6164.
The horizontal drivengear6182 and the vertical drivengear6192 are driven by anarticulation gear train6300 that operably interfaces with anarticulation shifter assembly6320. In at least one form, the articulation shifter assembly comprises anarticulation drive gear6322 that is coupled to a corresponding one of the driven discs orelements1304 on theadapter side1307 of thetool mounting plate6202. SeeFIG. 34. Thus, application of a rotary input motion from therobotic system1000 through thetool drive assembly1010 to the corresponding drivenelement1304 will cause rotation of thearticulation drive gear6322 when theinterface1230 is coupled to thetool holder1270. An articulation drivengear6324 is attached to asplined shifter shaft6330 that is rotatably supported on thetool mounting plate6202. The articulation drivengear6324 is in meshing engagement with thearticulation drive gear6322 as shown. Thus, rotation of thearticulation drive gear6322 will result in the rotation of theshaft6330. In various forms, a shifter drivengear assembly6340 is movably supported on thesplined portion6332 of theshifter shaft6330.
In various embodiments, the shifter drivengear assembly6340 includes a drivenshifter gear6342 that is attached to ashifter plate6344. Theshifter plate6344 operably interfaces with ashifter solenoid assembly6350. Theshifter solenoid assembly6350 is coupled to correspondingpins6352 byconductors6352. SeeFIG. 139.Pins6352 are oriented to electrically communicate with slots1258 (FIG. 33) on thetool side1244 of theadaptor1240. Such arrangement serves to electrically couple theshifter solenoid assembly6350 to therobotic controller1001. Thus, activation of theshifter solenoid6350 will shift the shifter drivengear assembly6340 on thesplined portion6332 of theshifter shaft6330 as represented by arrow “S” inFIGS. 139 and 140. Various embodiments of thearticulation gear train6300 further include a horizontal gear assembly6360 that includes a firsthorizontal drive gear6362 that is mounted on ashaft6361 that is rotatably attached to thetool mounting plate6202. The firsthorizontal drive gear6362 is supported in meshing engagement with a secondhorizontal drive gear6364. As can be seen inFIG. 140, the horizontal drivengear6182 is in meshing engagement with thedistal face portion6365 of the second horizontal drivengear6364.
Various embodiments of thearticulation gear train6300 further include avertical gear assembly6370 that includes a firstvertical drive gear6372 that is mounted on ashaft6371 that is rotatably supported on thetool mounting plate6202. The firstvertical drive gear6372 is supported in meshing engagement with a secondvertical drive gear6374 that is concentrically supported with the secondhorizontal drive gear6364. The secondvertical drive gear6374 is rotatably supported on theproximal spine portion6110 for travel therearound. The secondhorizontal drive gear6364 is rotatably supported on a portion of said secondvertical drive gear6374 for independent rotatable travel thereon. As can be seen inFIG. 140, the vertical drivengear6192 is in meshing engagement with thedistal face portion6375 of the second vertical drivengear6374.
In various forms, the firsthorizontal drive gear6362 has a first diameter and the firstvertical drive gear6372 has a second diameter. As can be seen inFIGS. 139 and 140, theshaft6361 is not on a common axis withshaft6371. That is, the first horizontal drivengear6362 and the first vertical drivengear6372 do not rotate about a common axis. Thus, when theshifter gear6342 is positioned in a center “locking” position such that theshifter gear6342 is in meshing engagement with both the first horizontal drivengear6362 and the firstvertical drive gear6372, the components of thearticulation system6140 are locked in position. Thus, theshiftable shifter gear6342 and the arrangement of first horizontal and vertical drive gears6362,6372 as well as thearticulation shifter assembly6320 collectively may be referred to as an articulation locking system, generally designated as6380.
In use, therobotic controller1001 of therobotic system1000 may control thearticulation system6140 as follows. To articulate theend effector6012 to the left about the first tool articulation axis TA1-TA1, therobotic controller1001 activates theshifter solenoid assembly6350 to bring theshifter gear6342 into meshing engagement with the firsthorizontal drive gear6362. Thereafter, thecontroller1001 causes a first rotary output motion to be applied to thearticulation drive gear6322 to drive the shifter gear in a first direction to ultimately drive the horizontal drivengear6182 in another first direction. The horizontal drivengear6182 is driven to pivot thearticulation ring6164 on the ball-shapedportion6162 to thereby pull rightupper cable6144 and the rightlower cable6146 in the proximal direction “PD”. To articulate theend effector6012 to the right about the first tool articulation axis TA1-TA1, therobotic controller1001 activates theshifter solenoid assembly6350 to bring theshifter gear6342 into meshing engagement with the firsthorizontal drive gear6362. Thereafter, thecontroller1001 causes the first rotary output motion in an opposite direction to be applied to thearticulation drive gear6322 to drive theshifter gear6342 in a second direction to ultimately drive the horizontal drivengear6182 in another second direction. Such actions result in thearticulation control ring6164 moving in such a manner as to pull the leftupper cable6150 and the leftlower cable6152 in the proximal direction “PD”. In various embodiments the gear ratios and frictional forces generated between the gears of thevertical gear assembly6370 serve to prevent rotation of the vertical drivengear6192 as the horizontal gear assembly6360 is actuated.
To articulate theend effector6012 in the upper direction about the second tool articulation axis TA2-TA2, therobotic controller1001 activates theshifter solenoid assembly6350 to bring theshifter gear6342 into meshing engagement with the firstvertical drive gear6372. Thereafter, thecontroller1001 causes the first rotary output motion to be applied to thearticulation drive gear6322 to drive theshifter gear6342 in a first direction to ultimately drive the vertical drivengear6192 in another first direction. The vertical drivengear6192 is driven to pivot thearticulation ring6164 on the ball-shapedportion6162 of theproximal spine portion6110 to thereby pull rightupper cable6144 and the leftupper cable6150 in the proximal direction “PD”. To articulate theend effector6012 in the downward direction about the second tool articulation axis TA2-TA2, therobotic controller1001 activates theshifter solenoid assembly6350 to bring theshifter gear6342 into meshing engagement with the firstvertical drive gear6372. Thereafter, thecontroller1001 causes the first rotary output motion to be applied in an opposite direction to thearticulation drive gear6322 to drive theshifter gear6342 in a second direction to ultimately drive the vertical drivengear6192 in another second direction. Such actions thereby cause thearticulation control ring6164 to pull the rightlower cable6146 and the leftlower cable6152 in the proximal direction “PD”. In various embodiments, the gear ratios and frictional forces generated between the gears of the horizontal gear assembly6360 serve to prevent rotation of the horizontal drivengear6182 as thevertical gear assembly6370 is actuated.
In various embodiments, a variety of sensors may communicate with therobotic controller1001 to determine the articulated position of theend effector6012. Such sensors may interface with, for example, the articulation joint6100 or be located within thetool mounting portion6200. For example, sensors may be employed to detect the position of thearticulation control ring6164 on the ball-shapedportion6162 of theproximal spine portion6110. Such feedback from the sensors to thecontroller1001 permits thecontroller1001 to adjust the amount of rotation and the direction of the rotary output to thearticulation drive gear6322. Further, as indicated above, when theshifter drive gear6342 is centrally positioned in meshing engagement with the firsthorizontal drive gear6362 and the firstvertical drive gear6372, theend effector6012 is locked in the articulated position. Thus, after the desired amount of articulation has been attained, thecontroller1001 may activate theshifter solenoid assembly6350 to bring theshifter gear6342 into meshing engagement with the firsthorizontal drive gear6362 and the firstvertical drive gear6372. In alternative embodiments, theshifter solenoid assembly6350 may be spring activated to the central locked position.
In use, it may be desirable to rotate thesurgical end effector6012 about the longitudinal tool axis LT-LT. In at least one embodiment, the transmission arrangement6204 on the tool mounting portion includes arotational transmission assembly6400 that is configured to receive a corresponding rotary output motion from thetool drive assembly1010 of therobotic system1000 and convert that rotary output motion to a rotary control motion for rotating the elongated shaft assembly6008 (and surgical end effector6012) about the longitudinal tool axis LT-LT. In various embodiments, for example, aproximal end portion6041 of theproximal closure tube6040 is rotatably supported on thetool mounting plate6202 of thetool mounting portion6200 by aforward support cradle6205 and aclosure sled6510 that is also movably supported on thetool mounting plate6202. In at least one form, therotational transmission assembly6400 includes atube gear segment6402 that is formed on (or attached to) theproximal end6041 of theproximal closure tube6040 for operable engagement by arotational gear assembly6410 that is operably supported on thetool mounting plate6202. As can be seen inFIG. 139, therotational gear assembly6410, in at least one embodiment, comprises arotation drive gear6412 that is coupled to a corresponding second one of the driven discs orelements1304 on theadapter side1307 of thetool mounting plate6202 when thetool mounting portion6200 is coupled to thetool drive assembly1010. SeeFIG. 34. Therotational gear assembly6410 further comprises a first rotary drivengear6414 that is rotatably supported on thetool mounting plate6202 in meshing engagement with therotation drive gear6412. The first rotary drivengear6414 is attached to a drive shaft6416 that is rotatably supported on thetool mounting plate6202. A second rotary driven gear6418 is attached to the drive shaft6416 and is in meshing engagement withtube gear segment6402 on theproximal closure tube6040. Application of a second rotary output motion from thetool drive assembly1010 of therobotic system1000 to the corresponding drivenelement1304 will thereby cause rotation of therotation drive gear6412. Rotation of therotation drive gear6412 ultimately results in the rotation of the elongated shaft assembly6008 (and the surgical end effector6012) about the longitudinal tool axis LT-LT. It will be appreciated that the application of a rotary output motion from thetool drive assembly1010 in one direction will result in the rotation of theelongated shaft assembly6008 andsurgical end effector6012 about the longitudinal tool axis LT-LT in a first direction and an application of the rotary output motion in an opposite direction will result in the rotation of theelongated shaft assembly6008 andsurgical end effector6012 in a second direction that is opposite to the first direction.
In at least one embodiment, the closure of theanvil2024 relative to thestaple cartridge2034 is accomplished by axially moving a closure portion of theelongated shaft assembly2008 in the distal direction “DD” on the spine assembly2049. As indicated above, in various embodiments, theproximal end portion6041 of theproximal closure tube6040 is supported by theclosure sled6510 which comprises a portion of a closure transmission, generally depicted as6512. As can be seen inFIG. 139, theproximal end portion6041 of the proximalclosure tube portion6040 has acollar6048 formed thereon. Theclosure sled6510 is coupled to thecollar6048 by ayoke6514 that engages anannular groove6049 in thecollar6048. Such arrangement serves to enable thecollar6048 to rotate about the longitudinal tool axis LT-LT while still being coupled to theclosure transmission6512. In various embodiments, theclosure sled6510 has anupstanding portion6516 that has aclosure rack gear6518 formed thereon. Theclosure rack gear6518 is configured for driving engagement with aclosure gear assembly6520. SeeFIG. 139.
In various forms, theclosure gear assembly6520 includes aclosure spur gear6522 that is coupled to a corresponding second one of the driven discs orelements1304 on theadapter side1307 of thetool mounting plate6202. SeeFIG. 34. Thus, application of a third rotary output motion from thetool drive assembly1010 of therobotic system1000 to the corresponding second drivenelement1304 will cause rotation of theclosure spur gear6522 when thetool mounting portion6202 is coupled to thetool drive assembly1010. Theclosure gear assembly6520 further includes a closure reduction gear set6524 that is supported in meshing engagement with theclosure spur gear6522 and theclosure rack gear2106. Thus, application of a third rotary output motion from thetool drive assembly1010 of therobotic system1000 to the corresponding second drivenelement1304 will cause rotation of theclosure spur gear6522 and theclosure transmission6512 and ultimately drive theclosure sled6510 and theproximal closure tube6040 axially on theproximal spine portion6110. The axial direction in which theproximal closure tube6040 moves ultimately depends upon the direction in which the third drivenelement1304 is rotated. For example, in response to one rotary output motion received from thetool drive assembly1010 of therobotic system1000, theclosure sled6510 will be driven in the distal direction “DD” and ultimately drive theproximal closure tube6040 in the distal direction “DD”. As theproximal closure tube6040 is driven distally, thedistal closure tube6042 is also driven distally by virtue of it connection with theproximal closure tube6040. As thedistal closure tube6042 is driven distally, the end of theclosure tube6042 will engage a portion of theanvil6024 and cause theanvil6024 to pivot to a closed position. Upon application of an “opening” out put motion from thetool drive assembly1010 of therobotic system1000, theclosure sled6510 and theproximal closure tube6040 will be driven in the proximal direction “PD” on theproximal spine portion6110. As theproximal closure tube6040 is driven in the proximal direction “PD”, thedistal closure tube6042 will also be driven in the proximal direction “PD”. As thedistal closure tube6042 is driven in the proximal direction “PD”, theopening6045 therein interacts with thetab6027 on theanvil6024 to facilitate the opening thereof. In various embodiments, a spring (not shown) may be employed to bias theanvil6024 to the open position when thedistal closure tube6042 has been moved to its starting position. In various embodiments, the various gears of theclosure gear assembly6520 are sized to generate the necessary closure forces needed to satisfactorily close theanvil6024 onto the tissue to be cut and stapled by thesurgical end effector6012. For example, the gears of theclosure transmission6520 may be sized to generate approximately 70-120 pounds of closure forces.
In various embodiments, the cutting instrument is driven through thesurgical end effector6012 by aknife bar6530. SeeFIG. 139. In at least one form, theknife bar6530 is fabricated with a joint arrangement (not shown) and/or is fabricated from material that can accommodate the articulation of thesurgical end effector6102 about the first and second tool articulation axes while remaining sufficiently rigid so as to push the cutting instrument through tissue clamped in thesurgical end effector6012. Theknife bar6530 extends through ahollow passage6532 in theproximal spine portion6110.
In various embodiments, aproximal end6534 of theknife bar6530 is rotatably affixed to aknife rack gear6540 such that theknife bar6530 is free to rotate relative to theknife rack gear6540. The distal end of theknife bar6530 is attached to the cutting instrument in the various manners described above. As can be seen inFIG. 139, theknife rack gear6540 is slidably supported within arack housing6542 that is attached to thetool mounting plate6202 such that theknife rack gear6540 is retained in meshing engagement with a knifedrive transmission portion6550 of the transmission arrangement6204. In various embodiments, the knifedrive transmission portion6550 comprises aknife gear assembly6560. More specifically and with reference toFIG. 139, in at least one embodiment, theknife gear assembly6560 includes aknife spur gear6562 that is coupled to a corresponding fourth one of the driven discs orelements1304 on theadapter side1307 of thetool mounting plate6202. SeeFIG. 34. Thus, application of another rotary output motion from therobotic system1000 through thetool drive assembly1010 to the corresponding fourth drivenelement1304 will cause rotation of theknife spur gear6562. Theknife gear assembly6560 further includes a knife gear reduction set6564 that includes a first knife drivengear6566 and a secondknife drive gear6568. The knife gear reduction set6564 is rotatably mounted to thetool mounting plate6202 such that the first knife drivengear6566 is in meshing engagement with theknife spur gear6562. Likewise, the secondknife drive gear6568 is in meshing engagement with a third knifedrive gear assembly6570. As shown inFIG. 139, the second knife drivengear6568 is in meshing engagement with a fourth knife drivengear6572 of the third knifedrive gear assembly6570. The fourth knife drivengear6572 is in meshing engagement with a fifth knife drivengear assembly6574 that is in meshing engagement with theknife rack gear6540. In various embodiments, the gears of theknife gear assembly6560 are sized to generate the forces needed to drive the cutting instrument through the tissue clamped in thesurgical end effector6012 and actuate the staples therein. For example, the gears of theknife gear assembly6560 may be sized to generate approximately 40 to 100 pounds of driving force. It will be appreciated that the application of a rotary output motion from thetool drive assembly1010 in one direction will result in the axial movement of the cutting instrument in a distal direction and application of the rotary output motion in an opposite direction will result in the axial travel of the cutting instrument in a proximal direction.
As can be appreciated from the foregoing description, thesurgical tool6000 represents a vast improvement over prior robotic tool arrangements. The unique and novel transmission arrangement employed by thesurgical tool6000 enables the tool to be operably coupled to atool holder portion1010 of a robotic system that only has four rotary output bodies, yet obtain the rotary output motions therefrom to: (i) articulate the end effector about two different articulation axes that are substantially transverse to each other as well as the longitudinal tool axis; (ii) rotate theend effector6012 about the longitudinal tool axis; (iii) close theanvil6024 relative to thesurgical staple cartridge6034 to varying degrees to enable theend effector6012 to be used to manipulate tissue and then clamp it into position for cutting and stapling; and (iv) firing the cutting instrument to cut through the tissue clamped within theend effector6012. The unique and novel shifter arrangements of various embodiments of the present invention described above enable two different articulation actions to be powered from a single rotatable body portion of the robotic system.
The various embodiments of the present invention have been described above in connection with cutting-type surgical instruments. It should be noted, however, that in other embodiments, the inventive surgical instrument disclosed herein need not be a cutting-type surgical instrument, but rather could be used in any type of surgical instrument including remote sensor transponders. For example, it could be a non-cutting endoscopic instrument, a grasper, a stapler, a clip applier, an access device, a drug/gene therapy delivery device, an energy device using ultrasound, RF, laser, etc. In addition, the present invention may be in laparoscopic instruments, for example. The present invention also has application in conventional endoscopic and open surgical instrumentation as well as robotic-assisted surgery.
FIG. 141 depicts use of various aspects of certain embodiments of the present invention in connection with asurgical tool7000 that has an ultrasonicallypowered end effector7012. Theend effector7012 is operably attached to atool mounting portion7100 by an elongated shaft assembly7008. Thetool mounting portion7100 may be substantially similar to the various tool mounting portions described hereinabove. In one embodiment, theend effector7012 includes an ultrasonicallypowered jaw portion7014 that is powered by alternating current or direct current in a known manner. Such ultrasonically-powered devices are disclosed, for example, in U.S. Pat. No. 6,783,524, entitled “Robotic Surgical Tool With Ultrasound Cauterizing and Cutting Instrument”, the entire disclosure of which is herein incorporated by reference. In the illustrated embodiment, aseparate power cord7020 is shown. It will be understood, however, that the power may be supplied thereto from therobotic controller1001 through thetool mounting portion7100. Thesurgical end effector7012 further includes amovable jaw7016 that may be used to clamp tissue onto theultrasonic jaw portion7014. Themovable jaw portion7016 may be selectively actuated by therobotic controller1001 through thetool mounting portion7100 in anyone of the various manners herein described.
FIG. 142 illustrates use of various aspects of certain embodiments of the present invention in connection with asurgical tool8000 that has anend effector8012 that comprises a linear stapling device. Theend effector8012 is operably attached to atool mounting portion8100 by anelongated shaft assembly3700 of the type and construction describe above. However, theend effector8012 may be attached to thetool mounting portion8100 by a variety of other elongated shaft assemblies described herein. In one embodiment, thetool mounting portion8100 may be substantially similar totool mounting portion3750. However, various other tool mounting portions and their respective transmission arrangements describe in detail herein may also be employed. Such linear stapling head portions are also disclosed, for example, in U.S. Pat. No. 7,673,781, entitled “Surgical Stapling Device With Staple Driver That Supports Multiple Wire Diameter Staples”, the entire disclosure of which is herein incorporated by reference.
Various sensor embodiments described in U.S. Patent Publication No. 2011/0062212 A1 to Shelton, IV et al., now U.S. pat. No. 8,167,185,the disclosure of which is herein incorporated by reference in its entirety, may be employed with many of the surgical tool embodiments disclosed herein. As was indicated above, themaster controller1001 generally includes master controllers (generally represented by1003) which are grasped by the surgeon and manipulated in space while the surgeon views the procedure via astereo display1002. SeeFIG. 25. Themaster controllers1001 are manual input devices which preferably move with multiple degrees of freedom, and which often further have an actuatable handle for actuating the surgical tools. Some of the surgical tool embodiments disclosed herein employ a motor or motors in their tool drive portion to supply various control motions to the tool's end effector. Such embodiments may also obtain additional control motion(s) from the motor arrangement employed in the robotic system components. Other embodiments disclosed herein obtain all of the control motions from motor arrangements within the robotic system.
Such motor powered arrangements may employ various sensor arrangements that are disclosed in the published US patent application cited above to provide the surgeon with a variety of forms of feedback without departing from the spirit and scope of the present invention. For example, thosemaster controller arrangements1003 that employ a manually actuatable firing trigger can employ run motor sensor(s) to provide the surgeon with feedback relating to the amount of force applied to or being experienced by the cutting member. The run motor sensor(s) may be configured for communication with the firing trigger portion to detect when the firing trigger portion has been actuated to commence the cutting/stapling operation by the end effector. The run motor sensor may be a proportional sensor such as, for example, a rheostat or variable resistor. When the firing trigger is drawn in, the sensor detects the movement, and sends an electrical signal indicative of the voltage (or power) to be supplied to the corresponding motor. When the sensor is a variable resistor or the like, the rotation of the motor may be generally proportional to the amount of movement of the firing trigger. That is, if the operator only draws or closes the firing trigger in a small amount, the rotation of the motor is relatively low. When the firing trigger is fully drawn in (or in the fully closed position), the rotation of the motor is at its maximum. In other words, the harder the surgeon pulls on the firing trigger, the more voltage is applied to the motor causing greater rates of rotation. Other arrangements may provide the surgeon with a feed backmeter1005 that may be viewed through thedisplay1002 and provide the surgeon with a visual indication of the amount of force being applied to the cutting instrument or dynamic clamping member. Other sensor arrangements may be employed to provide themaster controller1001 with an indication as to whether a staple cartridge has been loaded into the end effector, whether the anvil has been moved to a closed position prior to firing, etc.
In alternative embodiments, a motor-controlled interface may be employed in connection with thecontroller1001 that limit the maximum trigger pull based on the amount of loading (e.g., clamping force, cutting force, etc.) experienced by the surgical end effector. For example, the harder it is to drive the cutting instrument through the tissue clamped within the end effector, the harder it would be to pull/actuate the activation trigger. In still other embodiments, the trigger on thecontroller1001 is arranged such that the trigger pull location is proportionate to the end effector-location/condition. For example, the trigger is only fully depressed when the end effector is fully fired.
In still other embodiments, the various robotic systems and tools disclosed herein may employ many of the sensor/transponder arrangements disclosed above. Such sensor arrangements may include, but are not limited to, run motor sensors, reverse motor sensors, stop motor sensors, end-of-stroke sensors, beginning-of-stroke sensors, cartridge lockout sensors, sensor transponders, charge accumulating devices, switching circuits, removable battery packs, etc. The sensors may be employed in connection with any of the surgical tools disclosed herein that are adapted for use with a robotic system. The sensors may be configured to communicate with the robotic system controller. In other embodiments, components of the shaft/end effector may serve as antennas to communicate between the sensors and the robotic controller. In still other embodiments, the various remote programming device arrangements described above may also be employed with the robotic controller.
The devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either case, however, the device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, the device can be disassembled, and any number of the particular pieces or parts of the device can be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, the device can be reassembled for subsequent use either at a reconditioning facility, or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that reconditioning of a device can utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.
Although the present invention has been described herein in connection with certain disclosed embodiments, many modifications and variations to those embodiments may be implemented. For example, different types of end effectors may be employed. Also, where materials are disclosed for certain components, other materials may be used. The foregoing description and following claims are intended to cover all such modification and variations.
Any patent, publication, or other disclosure material, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated materials does not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material.

Claims (13)

What is claimed is:
1. A surgical tool for use with a robotic system, the surgical tool comprising:
a shaft;
an end effector extending distally from the shaft, the end effector comprising:
a first jaw member; and
a second jaw member movable relative to the first jaw member about a pivot from a closed position to an open position in response to at least one axial motion;
an articulation joint disposed proximal to the pivot, wherein the end effector is rotatable relative to the shaft about the articulation joint;
a motor configured to generate at least one rotational motion; and
a motion conversion assembly operably coupled to the motor and the second jaw member, wherein the motion conversion assembly is configured to convert the at least one rotational motion to the at least one axial motion.
2. The surgical tool ofclaim 1, wherein the second jaw member is movable relative to the first jaw member from the open position to the closed position in response to at least one opposite axial motion, wherein the motor is configured to generate at least one opposite rotational motion, and wherein the motion conversion assembly is configured to convert the at least one opposite rotational motion to the at least one opposite axial motion.
3. The surgical tool ofclaim 1, wherein the motion conversion assembly comprises:
an actuation member in operable communication with the second jaw member; and
a rotary input in operable communication with the motor, wherein the rotary input is configured to receive the at least one rotational motion from the motor, and wherein the actuation member is configured to transmit the at least one axial motion to the second jaw member.
4. The surgical tool ofclaim 3, wherein the actuation member is in threaded engagement with the rotary input.
5. The surgical tool ofclaim 1 further comprising a power source configured to provide power for the motor.
6. The surgical tool ofclaim 1, wherein the end effector further comprises a staple cartridge.
7. A surgical tool for use with a robotic system, the surgical tool comprising:
a shaft;
an end effector extending distally from the shaft, the end effector comprising:
a first jaw member; and
a second jaw member movable relative to the first jaw member about a pivot from an open position to a closed position;
an articulation ioint disposed proximal to the pivot, wherein the end effector is rotatable relative to the shaft about the articulation ioint;
closure camming means for camming the second jaw member relative to the first jaw member from the open position to the closed position;
rotary input means for driving the closure camming means; and
staple firing means distinct and independent from the closure camming means.
8. A surgical tool for use with a robotic system, the surgical tool comprising:
a shaft;
an end effector extending distally from the shaft, the end effector comprising:
a first jaw member; and
a second jaw member movable relative to the first jaw member about a pivot between an open position and a closed position;
an articulation joint disposed proximal to the pivot, wherein the end effector is rotatable relative to the shaft about the articulation joint;
a motor;
an axially movable drive member in operable communication with the second jaw member; and
a rotary drive shaft in operable communication with the motor, wherein the rotary drive shaft is in operable engagement with the axially movable drive member, and wherein at least one rotational motion of the rotary drive shaft causes the axially movable drive member to move the second jaw member relative to the first jaw member from the closed position to the open position.
9. The surgical tool ofclaim 8, wherein at least one opposite rotational motion of the rotary drive shaft causes the axially movable drive member to move the second jaw member relative to the first jaw member from the open position to the closed position.
10. The surgical tool ofclaim 8, wherein the second jaw member comprises a slot, and wherein the axially movable drive member comprises a camming member movable through the slot to move the second jaw member relative to the first jaw member from the closed position to the open position.
11. The surgical tool ofclaim 8, wherein the axially movable drive member is configured to apply actuation forces onto the first jaw member and the second jaw member simultaneously.
12. The surgical tool ofclaim 8, wherein the rotary drive shaft is in threaded engagement with the axially movable drive member.
13. The surgical tool ofclaim 8, wherein the end effector further comprises a staple cartridge.
US13/792,2632008-09-232013-03-11Robotically-controlled motorized surgical instrument with an end effectorActive2030-10-02US9655614B2 (en)

Priority Applications (12)

Application NumberPriority DateFiling DateTitle
US13/792,263US9655614B2 (en)2008-09-232013-03-11Robotically-controlled motorized surgical instrument with an end effector
US15/274,784US10105136B2 (en)2008-09-232016-09-23Robotically-controlled motorized surgical instrument with an end effector
US15/274,826US10130361B2 (en)2008-09-232016-09-23Robotically-controller motorized surgical tool with an end effector
US15/274,805US10045778B2 (en)2008-09-232016-09-23Robotically-controlled motorized surgical instrument with an end effector
US15/274,847US10238389B2 (en)2008-09-232016-09-23Robotically-controlled motorized surgical instrument with an end effector
US16/146,335US10765425B2 (en)2008-09-232018-09-28Robotically-controlled motorized surgical instrument with an end effector
US16/146,367US10980534B2 (en)2011-05-272018-09-28Robotically-controlled motorized surgical instrument with an end effector
US16/903,791US10980535B2 (en)2008-09-232020-06-17Motorized surgical instrument with an end effector
US16/903,803US11045189B2 (en)2008-09-232020-06-17Robotically-controlled motorized surgical instrument with an end effector
US17/242,766US11812954B2 (en)2008-09-232021-04-28Robotically-controlled motorized surgical instrument with an end effector
US17/709,590US11648005B2 (en)2008-09-232022-03-31Robotically-controlled motorized surgical instrument with an end effector
US17/719,501US20220240930A1 (en)2008-09-232022-04-13Robotically-controlled motorized surgical instrument with an end effector

Applications Claiming Priority (3)

Application NumberPriority DateFiling DateTitle
US12/235,972US9050083B2 (en)2008-09-232008-09-23Motorized surgical instrument
US13/118,253US9386983B2 (en)2008-09-232011-05-27Robotically-controlled motorized surgical instrument
US13/792,263US9655614B2 (en)2008-09-232013-03-11Robotically-controlled motorized surgical instrument with an end effector

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US13/118,253ContinuationUS9386983B2 (en)2008-09-232011-05-27Robotically-controlled motorized surgical instrument

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US15/274,826ContinuationUS10130361B2 (en)2008-09-232016-09-23Robotically-controller motorized surgical tool with an end effector
US15/274,784ContinuationUS10105136B2 (en)2008-09-232016-09-23Robotically-controlled motorized surgical instrument with an end effector
US15/274,805ContinuationUS10045778B2 (en)2008-09-232016-09-23Robotically-controlled motorized surgical instrument with an end effector
US15/274,847ContinuationUS10238389B2 (en)2008-09-232016-09-23Robotically-controlled motorized surgical instrument with an end effector

Publications (2)

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US20130193189A1 US20130193189A1 (en)2013-08-01
US9655614B2true US9655614B2 (en)2017-05-23

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Application NumberTitlePriority DateFiling Date
US13/118,253Active2029-11-06US9386983B2 (en)2008-09-232011-05-27Robotically-controlled motorized surgical instrument
US13/369,588ActiveUS8602288B2 (en)2008-09-232012-02-09Robotically-controlled motorized surgical end effector system with rotary actuated closure systems having variable actuation speeds
US13/792,263Active2030-10-02US9655614B2 (en)2008-09-232013-03-11Robotically-controlled motorized surgical instrument with an end effector
US15/274,805ActiveUS10045778B2 (en)2008-09-232016-09-23Robotically-controlled motorized surgical instrument with an end effector
US15/274,826ActiveUS10130361B2 (en)2008-09-232016-09-23Robotically-controller motorized surgical tool with an end effector
US15/274,847ActiveUS10238389B2 (en)2008-09-232016-09-23Robotically-controlled motorized surgical instrument with an end effector
US15/274,784ActiveUS10105136B2 (en)2008-09-232016-09-23Robotically-controlled motorized surgical instrument with an end effector
US16/146,335ActiveUS10765425B2 (en)2008-09-232018-09-28Robotically-controlled motorized surgical instrument with an end effector
US16/146,367Active2031-10-10US10980534B2 (en)2011-05-272018-09-28Robotically-controlled motorized surgical instrument with an end effector
US16/903,791ActiveUS10980535B2 (en)2008-09-232020-06-17Motorized surgical instrument with an end effector
US16/903,803ActiveUS11045189B2 (en)2008-09-232020-06-17Robotically-controlled motorized surgical instrument with an end effector
US17/242,766Active2029-04-06US11812954B2 (en)2008-09-232021-04-28Robotically-controlled motorized surgical instrument with an end effector

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US13/118,253Active2029-11-06US9386983B2 (en)2008-09-232011-05-27Robotically-controlled motorized surgical instrument
US13/369,588ActiveUS8602288B2 (en)2008-09-232012-02-09Robotically-controlled motorized surgical end effector system with rotary actuated closure systems having variable actuation speeds

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US15/274,805ActiveUS10045778B2 (en)2008-09-232016-09-23Robotically-controlled motorized surgical instrument with an end effector
US15/274,826ActiveUS10130361B2 (en)2008-09-232016-09-23Robotically-controller motorized surgical tool with an end effector
US15/274,847ActiveUS10238389B2 (en)2008-09-232016-09-23Robotically-controlled motorized surgical instrument with an end effector
US15/274,784ActiveUS10105136B2 (en)2008-09-232016-09-23Robotically-controlled motorized surgical instrument with an end effector
US16/146,335ActiveUS10765425B2 (en)2008-09-232018-09-28Robotically-controlled motorized surgical instrument with an end effector
US16/146,367Active2031-10-10US10980534B2 (en)2011-05-272018-09-28Robotically-controlled motorized surgical instrument with an end effector
US16/903,791ActiveUS10980535B2 (en)2008-09-232020-06-17Motorized surgical instrument with an end effector
US16/903,803ActiveUS11045189B2 (en)2008-09-232020-06-17Robotically-controlled motorized surgical instrument with an end effector
US17/242,766Active2029-04-06US11812954B2 (en)2008-09-232021-04-28Robotically-controlled motorized surgical instrument with an end effector

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US (12)US9386983B2 (en)
EP (1)EP2713896A1 (en)
CN (1)CN103687552A (en)
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WO (1)WO2012166517A1 (en)

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US20190099177A1 (en)2019-04-04
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US20110295269A1 (en)2011-12-01
US10980535B2 (en)2021-04-20
US20200315615A1 (en)2020-10-08
BR112013030494A2 (en)2016-09-27
US8602288B2 (en)2013-12-10
US20120199631A1 (en)2012-08-09
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US10765425B2 (en)2020-09-08
US20170007340A1 (en)2017-01-12
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US20170007339A1 (en)2017-01-12
US10105136B2 (en)2018-10-23
US10238389B2 (en)2019-03-26
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US9386983B2 (en)2016-07-12
US20190029677A1 (en)2019-01-31
US11812954B2 (en)2023-11-14
US10130361B2 (en)2018-11-20
US20170007338A1 (en)2017-01-12
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US20170007341A1 (en)2017-01-12
US20130193189A1 (en)2013-08-01

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